A population based study of herpes simplex virus 2 seroprevalence in rural Costa Rica

A. C. Rodríguez, Philip E. Castle, J. S. Smith, C. Bratti, A. Hildesheim, M. Schiffman, R. Viscidi, R. D. Burk, R. L. Ashley, X. Castellsagué, R. Herrero

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Objectives: To determine seroprevalence and determinants of herpes simplex virus 2 (HSV-2) seropositivity, in a random sample of a population based cohort of 10 049 women of Guanacaste, Costa Rica, using a highly sensitive and specific serological assay. Methods: Seroprevalence was determined by a type specific HSV-2 ELISA assay in an age stratified random sample of 1100 women. Univariate and multivariate logistic regression was used to calculate odds ratios and 95% confidence intervals for risk factors of seropositivity. Results: Overall age adjusted HSV-2 seroprevalence was 38.5% (95% CI, 37.5 to 39.5), and it was strongly associated with increasing age (pTrend<0.0001) , both among monogamous women and women with multiple sexual partners. A greater number of lifetime sexual partners increased the risk of seropositivity, with a 28.2% (95% CI, 24.4 to 32.2) seroprevalence among monogamous women and 75% (95% CI, 65.6 to 83.0) seroprevalence for those with four or more partners (OR=7.6 95% CI, 4.7 to 12.4 pTrend<0.0001). Barrier contraceptive use was negatively associated with HSV-2 seropositivity (OR 0.54, 95% CI, 0.31 to 0.94). Women with antibodies against HPV 16, 18, or 31 were 1.6 times more likely to be HSV-2 seropositive (OR 1.6, 95% CI, 1.2 to 2.1). Conclusions: HSV-2 infection is highly endemic in Guanacaste, even among lifetime monogamous women, suggesting a role of male behaviour in the transmission of the infection. Until vaccination against HSV-2 is available, education to prevent high risk sexual behaviour and the use of condoms appear as preventive measures against HSV-2.

Original languageEnglish (US)
Pages (from-to)460-465
Number of pages6
JournalSexually Transmitted Infections
Issue number6
StatePublished - Dec 2003

ASJC Scopus subject areas

  • Dermatology
  • Infectious Diseases


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