A new study found that more than one in four adults in the city of New York (compared with fewer than one in five nationally) is infected with the Herpes Simplex Virus-2 that causes genital herpes, a lifelong sexually transmitted disease that helps to spread HIV and can result in painful genital sores, although most people don’t notice any symptoms.

The study was carried out by lead author Dr Julia Schillinger, Director of Surveillance for the City’s Health Department’s Bureau of STD Prevention and Control, and is published this month in the journal Sexually Transmitted Diseases.

Infection with Herpes Simplex Virus-2 (HSV-2) lasts a lifetime and often has no recognizable symptoms. However, it is a worrying public health issue because it helps to spread HIV, and it can cause serious problems for newborns, although such cases are much rarer. A person exposed to HSV-2 has double the risk of contracting HIV.

To carry out the study Schilling and colleagues used data from the City’s 2004 Health and Nutrition Examination Survey (NYC HANES, modelled on the national version). This surveyed a representative sample of New York City adults aged 20 and over by conducting door to door interviews and personal medical exams to bring together a range of measures covering diabetes to depression, to assess the health of people living in New York. Of the 1,999 participants, 1,784 were tested for HSV-2.

The researchers found that genital herpes is more common among adults in New York City than it is among American adults overall: the infection rates were 26 per cent and 19 per cent respectively. More women appear to be infected than men (36 versus 19 per cent), more blacks than whites (49 versus 14 per cent), and more men who have sex with men are infected compared with those who do not (32 versus 18 per cent).

Also they found that over 80 per cent of infected adults were undiagnosed. And among HSV-2 infected individuals, non-Hispanic blacks (as opposed to non-Hispanic whites), uncircumcised men, and those with no routine place of care were less likely to be diagnosed.

The authors concluded that: “HSV-2 is highly prevalent and largely undiagnosed in New York City”, and they suggested that “targeted HSV-2 screening, counseling and treatment may help reduce transmission of HSV-2 and human immunodeficiency virus”.

Schillinger said that:

“Genital herpes alone will not cause serious problems for most people.”

But some people will have painful sores in their genital area, and the infection also helps the spread of HIV, added Schillinger, who advised New Yorkers to protect themselves and others:

“Using condoms consistently will help you avoid getting or spreading genital herpes,” she said.

Schilling and her co-investigators found that sexually active New Yorkers were not just at risk from genital herpes, but also from gonorrhea, chlamydia, and infectious syphilis, and that their risk of getting these infections were, like genital herpes, also above the national average. In 2007 alone, the city’s health department received over 65,000 reports of sexually transmitted infections.

Last autumn the city’s health department reported that HIV infection among young men who have sex with men was also on the rise.

The city’s Health Department had this advice for New Yorkers concerned they may be infected:

  • If you have genital sores, visit your doctor and ask for an evaluation.
  • New York City Health Department STD clinics offer free and confidential herpes testing for people who have sores.
  • You can call 311 to find out where your local clinic is and what times it opens.
  • Anti-herpes medications can help with outbreaks and reduce the chance of it being passed onto partners.
  • Blood testing for HSV-2 is not usually recommended, but your doctor may ask you to have one.
  • Your doctor may ask you to have a test if you: have sex with a partner who is known to be infected; are HIV positive or at high risk of HIV infection.

Schillinger expressed sympathy for people who suddenly find themselves diagnosed with genital herpes. It can be “overwhelming”, she said.

“People may feel ashamed because of the stigma the infection carries,” she said, and urged patients to tell their doctor or a mental health professional about their feelings:

“Help is available,” said Schilling.

The best way to prevent yourself from getting genital herpes is not to have sex. However, this is not a realistic option if you are sexually active, so protect yourself by:

  • Using a condom correctly every time you have sex.
  • New Yorkers can get free NYC condoms at many prominent locations in the city.
  • You can call 311 or go to www.nyc.gov/condoms for more information.
  • Take extra precautions if you or your sexual partner has genital herpes.
  • Genital herpes can spread even when sores are not present: having no symptoms does not mean you are not infectious.
  • Also, if you have a sore, don’t have sex at all until it is properly healed.
  • Ask your doctor about anti-herpes medications, they can reduce the spread of the virus.
  • Find and stay with a regular health care provider: research shows that people who have a “medical home” are more likely to get diagnosed.

“Seroprevalence of Herpes Simplex Virus Type 2 and Characteristics Associated With Undiagnosed Infection: New York City, 2004.”
Schillinger, Julia A; McKinney, Christy M; Garg, Renu; Gwynn, R Charon; White, Kellee; Lee, Francis; Blank, Susan; Thorpe, Lorna; and Frieden, Thomas.
Sexually Transmitted Diseases, 35(6):599-606, June 2008.

Click here for Abstract.

Click here for more information on genital herpes (CDC).

Source: New York City Department of Health and Mental Hygiene.

Written by: Catharine Paddock, PhD