Transmission of Herpes Simplex Virus Types 1 and 2 in a Prospective Cohort of HIV-Negative Gay Men: The Health in Men Study

There are few studies comparing risk factors for infection by herpes simplex virus types 1 (HSV-1) and 2 (HSV-2), the authors of the current study wrote, despite an increase in HSV-1-associated anogenital herpes reports. In that context, researchers examined the risk factors for prevalent and incident HSV-1 and HSV-2 infections in a community-based cohort of 1,427 HIV-negative gay men in Australia.

At baseline, HSV-1 and -2 prevalences were, respectively, 75 percent and 23 percent. However, the prevalence rates for either infection were much lower for people less than age 25. Each infection was associated with a higher number of both male and female sex partners.

Median follow-up was two years. Among participants susceptible to infection, HSV-1 and -2 incidence rates were 5.58 and 1.45 cases per 100 person-years, respectively. In multivariate analysis, HSV-1 incidence was significantly associated with younger age (P=0.027) and reports of frequent insertive oral sex with casual partners (hazard ratio, 3.91 [95 percent confident interval, 1.23-12.44]; P=0.021). Incident HSV-2 infection was significantly associated with various anal sex practices with casual partners.

While HSV-1 and -2 were both commonly transmitted sexually, "there were more HSV-1 than HSV-2 seroconversions," the authors concluded. "Public-health strategies targeted against anogenital herpes increasingly need to take into account the importance of HSV-1 infection."

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