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Okafor, Netochukwu Akinkunmi (2013)
Master's Thesis (53 pages)
Committee Chair / Thesis Adviser: Kelley, Colleen
Committee Members: Del Rio, Carlos
Research Fields: Health Sciences, Public Health; Health Sciences, General; Health Sciences, Medicine and Surgery
Partnering Agencies: Emory University schools, faculty or affiliated programs
Keywords: Herpes simplex virus type 2; HSV-2; herpes; HIV; infectious disease
Program: Rollins School of Public Health, Hubert Department of Global Health
Permanent url:


Background: Herpes simplex virus type 2 (HSV-2) is the most common cause of genital ulcer disease in the United States, and men who have sex with men (MSM) have higher prevalence of HSV-2. HSV-2 is one of the most important biologic predictors of HIV acquisition with infected persons having a 2.1 fold increased risk of HIV. Black MSM are disproportionately affected by HIV, and individual behavioral factors fail to explain this disparity suggesting that further investigation into biologic and network-level risk is warranted. This study aimed to estimate the seroprevalence of HSV-2 and examine associations with infection in a cohort of HIV negative black and white MSM. Methods: The InvolveMENt study is designed to examine factors that may contribute to disparities in HIV and sexually transmitted infections between black and white MSM aged 18-39 years in Atlanta, Georgia. Participants completed a survey at baseline evaluating demographic, individual, and community level risk factors and provided serum samples for HSV-2 serology. We examined the prevalence of HSV-2 and socio-demographic and behavioral associations with infection among HIV negative MSM using multivariate logistic regression. Results: Of the 394 men in the cohort, 210 were white and 184 were black. Seventy-seven (19.5%) were seropositive for HSV-2. Being black (OR 2.7; p=0.002), increasing age (OR 1.1; p=0.01), greater number of sexual partners in the past 12 months (OR 1.04; p=0.003), and a history of child abuse (OR 1.8; p=0.047) increased the odds of HSV-2 infection in a multivariate model. There was a significant interaction between race and age with black MSM <25 years of age having the highest odds of HSV-2 infection (OR=4.7; p=0.003). Conclusion: The odds of black MSM being infected with HSV-2 is 2.7 times more than white MSM. Our examination of socio-demographic and behavioral risk factors did not fully account for the disparity, especially among young black MSM. Further investigation into biologic/genetic and partner level factors in HSV-2 infection among MSM is warranted. As it remains an important risk factor for HIV acquisition, there is also continued need for research in the design and implementation of HSV-2 prevention programs specifically for young, black MSM.

Table of Contents

Table of Contents -- Introduction/Literature Review...1 -- Methods...15 -- Results...20 -- Discussion...23 -- References...29 -- Tables...41


application/pdf Master's Thesis 53 pages (246.1 KB) [Access copy of Master's Thesis]
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