In:
Sexually Transmitted Diseases, Ovid Technologies (Wolters Kluwer Health), Vol. 47, No. 3 ( 2020-3), p. 192-196
Abstract:
The HerpeSelect 2 ELISA IgG test for herpes simplex virus type 2 (HSV-2) infection is widely used, convenient, and inexpensive. However, it has been shown to have lower specificity among populations in Sub-Saharan Africa compared with HSV-2 tests regarded as criterion standards. Methods In 2016, we collected blood and survey data from 248 women participating in a community-based cohort study in rural Malawi (the Umoyo wa Thanzi project). Using multinomial logistic regression accounting for village-level clustering, we examined unadjusted associations between select demographic and sexual risk factors and HSV-2 serostatus. Because increasing the index value cutpoint for a positive result improves specificity, we coded HSV-2 serostatus in 2 ways: the manufacturer's recommended cutpoints ( 〈 0.9, negative; 0.9–1.1, indeterminate; 〉 1.1, positive) and modified cutpoints with improved specificity ( 〈 0.9, negative; 0.9–3.5, indeterminate; 〉 3.5, positive). We aimed to investigate whether associations between select risk factors and HSV-2 serostatus varied under the 2 approaches. Results The prevalence of HSV-2 in this sample was 67% under the manufacturer's cutpoint and 22% under the modified cutpoint. Under both cutpoints, age, household size, number of marriages, and number of pregnancies were associated with HSV-2–positive serostatus. Using modified cutpoints, current bacterial vaginosis (odds ratio [OR], 3.17; 95% confidence interval [CI] , 1.35–7.47), partner concurrency (OR, 4.88; 95% CI, 2.54–9.37) and unsure about partner concurrency (OR, 1.91; 95% CI, 1.08–3.38) were associated with HSV-2 seropositivity. Household size, education, and marital status were the only variables significantly associated with indeterminate HSV-2 serostatus using the modified cutpoints. Conclusion HSV-2-focused interventions informed by identifying individuals likely to have or acquire HSV-2 must be aware that different target populations may emerge depending on which cutpoints are adopted.
Type of Medium:
Online Resource
ISSN:
1537-4521
,
0148-5717
DOI:
10.1097/OLQ.0000000000001121
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2020
detail.hit.zdb_id:
2055170-8
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