Rural Center for AIDS/STD Prevention

RAP Time

(Volume 1, No. 1, November 7, 1997)

Issue Contents

Study Shows 20% of Adolescents and Adults May Be Infected with Genital Herpes

A recent report of a national study indicated that roughly one of five persons 12 years of age or older living in the United States may be infected with herpes simplex virus type 2 (HSV-2 or genital herpes). This represents an increase of 30 percent since the late 1970's.

An October 16, 1997 article in The New England Journal of Medicine describes results from the National Health and Nutrition Examination Surveys (NHANES) II (1976 to 1980) and 111(1988 to 1994). HSV-2 prevalence was measured by test of serum samples of 13,094 persons.

Description of Sample
Whites, Blacks, and Mexican Americans each comprised about one-third of the sample. Nearly equal number of females and males were involved in the study, with ages ranging from 12 to 70. About one-half were married, with about 61 percent having a high school education or less. About 22 percent had an income below poverty level and approximately 16 percent lived in nonurban areas.

Results of the Study
The study revealed that 21.9 percent of the subjects were infected with HSV-2. Projecting this percentage to the entire U.S. population, about 45 million Americans are estimated to have HSV-2.

Less than 10 percent of all those who tested positive for HSV-2 actually reported a history of genital herpes. HSV-2 infection was more common among women than men. About 26 percent and 18 percent of the women and men, respectively, were infected with HSV-2. This difference was attributed to biological differences in women and women choosing older sex partners.

The increases of HSV-2 infection between NHANES II and NHANES III were concentrated in the younger age groups. There were statistically significant increases overall in the three youngest age groups, encompasing persons from 12 to 39 years of age. Between the two study periods, prevalence of HSV-2 quintupled for White teenagers and doubled for Whites in their twenties. Increases for Blacks and older Whites were smaller.

Editor's Note: This is the inaugural issue of RAP Time. This monthly fax bulletin will highlight important HIV/STD information for prevention educators. Feel free to photocopy these bulletins. Persons desiring to receive RAP Time should contact RCAP.

Prediction of HSV-2 Infection
HSV-2 infection was predicted by less education, living below the poverty level, history of cocaine use, and a greater number of lifetime sex partners. Also, being female, older in age, Black, or Mexican American predicted HSV-2 infection. Marital status, age of sexual debut, and urban or nonurban residence did not predict HSV-2 infection.

Implications for HIV/STD Prevention
Findings suggest that HSV-2 is common in rural America. Educators should increase perceived vulnerability to STDs among rural residents. Increased awareness may motivate persons to increase condom use. In addition to reducing the risk of acquiring HSV-2, condom use can also help prevent HIV/STD infection. HSV-2 disease facilitates the sexual transmission of HIV infection.

SOURCE: Fleming, D. T., et al. (1997). Herpes simplex virus type 2 in the United States, 1976 to 1994. The New England Journal of Medicine, 337, 1105-1111.

NYC School Condom Program Assessed

The impact of the condom availability program in New York city public high schools was assessed by comparison of self-reported condom use between several thousand students in NYC and Chicago.

In 1991, the NYC schools began a non-clinic-based condom availability program. The program included HIV/AIDS education and a resource room where condoms were available. The Chicago program did provide HIV/AIDS education but did not make condoms available to students.

NYC students reported higher rates of condom use at last sexual intercourse than Chicago students. NYC students with three or more partners in the past six months were especially likely to use condoms at last intercourse. Rates of sexual activity were found to be similar between students in the two cities.

The study concluded that condom availability had a significant effect on condom use and does not increase sexual activity, suggesting that school-based condom availability can lower the risk of HIV/STDs for teenagers.

SOURCE: Guttmacher, S., et al. (1997). Condom availability in New York City Public High Schools: Relationships to condom use and sexual behavior. American Journal of Public Health, 87, 1427-1433.

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CDC Issues Midyear HIV/AIDS Report

The Centers for Disease Control and Prevention (CDC) midyear HIV/ AIDS surveillance report shows a cumulative incidence of U. S. AIDS cases that exceeds 612,000 persons. Of these, 84 percent were men, 15 percent were women, and 1 percent were children under the age of 13.

Sixty three percent of all male and 66 percent of all female AIDS cases were diagnosed for persons between 20 and 39 years of age. Using a ten year period of clinical latency to estimate date of HIV infection, these figures indicate that most HIV infections occur between the ages of 10 and 29.

Between July of 1996 and June of 1997, CDC reported 64,357 cases of AIDS among persons 13 years of age or older living in the United States. This represents a reduction of about 10 percent in new AIDS cases as compared to 71,376 AIDS cases reported in the previous year. CDC attributed this decrease to the effect of antiretroviral therapies on the survival of persons infected with HIV.

Over 200,00 persons in the United States are living with AIDS and 379,258 Americans have died from AIDS.

SOURCE: Centers for Disease Control and Prevention. (1997). HIV/AIDS Surveillance Report. Midyear Edition, 9(1).

AIDS Rises Quickly among U. S. Women

An analysis of United States AIDS cases indicates that AIDS incidence rates have increased for women in the South, women of younger ages and women who were infected through heterosexual intercourse. The study concluded that prevention programs must reach young women before they initiate sexual activity and drug use.

SOURCE: Wortely, P. M., & Fleming, P. L. (1997). AIDS in women in the United States: Recent trends. Journal of the American Medical Association, 278, 911-916.

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CDC Reports Increasing Rates of Gonorrhea among MSM

The incidence of gonorrhea (GC) among men who have sex with men *vlSM) declined substantially in the United States during the early 1980's. However, findings in both the United States and Europe indicate a possible reversal in GC trends among MSM. Relapses of high-risk behavior among MSM have been documented.

SOURCE: Morbidity and Mortality Weekly Report. (1997). Gonorrhea among men who have sex with men Selected sexually transmitted diseases clinics. 1993-1996. MMWR, 46, 889-892.