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1 September 2006

Volume 194, Number 5
The Journal of Infectious Diseases 2006;194:561–570
© 2006 by the Infectious Diseases Society of America. All rights reserved.
0022-1899/2006/19405-0005$15.00
DOI: 10.1086/506455
MAJOR ARTICLE

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

Fengyi Jin,1

Garrett P. Prestage,1

Limin Mao,2

Susan C. Kippax,2

Catherine M. Pell,6

Basil Donovan,1,3

David J. Templeton,1

Janette Taylor,5

Adrian Mindel,4

John M. Kaldor,1 and

Andrew E. Grulich1

National Centres in 1HIV Epidemiology and Clinical Research and 2HIV Social Research, University of New South Wales, 3Sydney Sexual Health Centre, Sydney Hospital, and 4Sexually Transmitted Infections Research Centre, Westmead Hospital and University of Sydney, Sydney, 5Westmead Millennium Institute, Centre for Virus Research, Westmead Hospital, Westmead, and 6Taylor Square Private Clinic, Darlinghurst, New South Wales, Australia

Background.Despite increasing reports of herpes simplex virus (HSV) type 1 (HSV‐1)–associated anogenital herpes, there are very limited data comparing the seroepidemiological profile of and risk factors for HSV‐1 and HSV type 2 (HSV‐2) infection.

Methods.Sexual behaviors were examined as risk factors for prevalent and incident HSV‐1 and HSV‐2 infections in a community‐based cohort of 1427 HIV‐negative gay men in Australia.

Results.The prevalence of HSV‐1 and HSV‐2 at baseline was 75% and 23%, respectively. The rate of prevalent infection with HSV‐1, as well as the rate of prevalent infection with HSV‐2, was much lower in individuals <25 years of age, and each type of infection was associated with a higher number of both male and female sex partners. The median duration of follow‐up of the cohort was 2.0 years. Among participants who were susceptible to infection, the incidence rates for HSV‐1 and HSV‐2 infection were 5.58 and 1.45 cases per 100 person‐years, respectively. In multivariate analysis, incident infection with HSV‐1 was significantly associated with younger age ( ) and reports of frequent insertive oral sex with casual partners (hazard ratio, 3.91 [95% confidence interval, 1.23–12.44]; ). Incident infection with HSV‐2 was significantly associated with a variety of anal sex practices with casual partners.

Conclusions.Both HSV‐1 and HSV‐2 were commonly sexually transmitted, and there were more HSV‐1 than HSV‐2 seroconversions. Public‐health strategies targeted against anogenital herpes increasingly need to take into account the importance of HSV‐1 infection.

Received 26 March 2006; accepted 28 April 2006; electronically published 28 July 2006.

Reprints or correspondence: Mr. Fengyi Jin, National Centre in HIV Epidemiology and Clinical Research, Level 2, 376 Victoria St., Darlinghurst, NSW 2010, Australia ().

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  • Financial support: The National Centre in HIV Epidemiology and Clinical Research and the National Centre in HIV Social Research are funded by the Australian Government Department of Health and Ageing. The project was funded by the Australian Government Department of Health and Ageing (Canberra) and the New South Wales Health Department (Sydney). The Health in Men Cohort Study was funded by the National Institutes of Health (NIH), a component of the US Department of Health and Human Services (NIH/National Institute of Allergy and Infectious Diseases/Division of AIDS: HVDDT award N01‐AI‐05395) and the National Health and Medical Research Council in Australia (grant 400944). Herpes testing was funded by GlaxoSmithKline.

    Potential conflicts of interest: D.J.T. and A.E.G. have received financial support for conference attendance and honorariums for educational activities from GlaxoSmithKline. All other authors: no conflicts.

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