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The trends in Herpes simplex virus type 1 (HSV-1) and Herpes simplex virus type 2 (HSV-2) seroprevalence was examined in the US in 1999-2004 compared with 1988-1994. Findings revealed that the decline in HSV-2 suggested that the trajectory of increasing HSV-2 seroprevalence in the US is reversed and decrease in seroprevalence of HSV-1 but increase in the incidence of genital herpes caused by HSV-1.

The National Health and Nutrition Examination Surveys (NHANES) are a series of cross-sectional surveys designed to provide national statistics on the health and nutritional status of the general household population through household interviews, standardized physical examinations, and the collection of biologic samples in special mobile examination centers. In NHANES III, race and/or ethnicity was categorized as non-Hispanic white, non-Hispanic African American and Mexican American.

Objectives. We examined racial/ethnic differences in the seroprevalence of selected infectious agents in analyses stratified according to risk categories to identify patterns and to determine whether demographic, socioeconomic, and behavioral characteristics explain these differences. Methods. We analyzed data from the third National Health and Nutrition Examination Survey, comparing differences among groups in regard to the prevalence of infection with hepatitis A, B, and C viruses, Toxoplasma gondii, Helicobacter pylori, and herpes simplex virus type 2. Results. Racial/ethnic differences were greater among those in the low-risk category. In the case of most infectious agents, odds associated with race/ethnicity were almost 2 times greater in that category than in the high-risk category. Conclusions. Stratification and adjustment for socioeconomic factors reduced or eliminated racial/ethnic differences in the prevalence of infection in the high-risk but not the low-risk group, wherein race/ethnicity remained significant and might have been a surrogate for unmeasured risk factors.

An estimated 4 million Americans are infected with the hepatitis C virus and 2.7 million are chronically infected, according to blood tests on 21,241 people participating in the third National Health and Nutrition Examination between 1988 and 1994. The biggest risk factors in this sample of people were illegal drug use and risky sexual practices. Poverty, lack of education and being divorced or separated were also risk factors.

The number of people infected with herpes simplex virus type 2 (HSV-2) has increased substantially since the late 1970's. Questionnaires were completed and blood samples were analyzed from 40,000 people aged 12 years and older during 1988 to 1994 and compared with data collected on 28,000 similar subjects during 1976 to 1980. The percentage of HSV-2-infected individuals rose by 30% between these two time periods. Individuals most likely to be infected were women, Mexican-Americans, blacks, and those who were poor, uneducated, sexually active with multiple partners, older, or who used cocaine.

Many adults and elderly people may not be adequately immunized against tetanus. Data from 10,618 people six years of age and older examined during the third National Health and Nutrition Examination Survey (NHANES) between 1988 and 1991 reveal that the percentage of people who are adequately immunized begins to drop substantially after the age of 40. Ninety-six percent of six-year-old children examined were adequately immunized, compared to 27.8% of those 70 years or older. Twenty percent of children aged 10 to 16 are not adequately immunized. A greater percentage of men were adequately protected longer, possibly because men have more accidents that require booster shots. The pattern of declining immunity was also present in blacks and Hispanics. A smaller percentage of the poor, uneducated and foreign-born had adequate protection against tetanus. Booster shots every 10 or 20 years may protect adults from tetanus.

Objectives. The Dallas County study of a proposed national household seroprevalence survey was designed to assess the feasibility of conducting a national survey and to estimate the prevalence of human immunodeficiency virus (HIV) and hepatitis B virus infection for Dallas County. Risk behavior data were collected and correlated with HIV infection. Methods. Participants in this survey represented a probability sample of the county. A self-administered questionnaire on demographic characteristics and HIV risk behavior was completed and a blood sample was obtained. Results. Of the 1724 adults eligible for the survey, 1446 completed the questionnaire and 1374 provided a blood sample. The prevalence estimates were 0.4% for HIV and 7.3% for hepatitis B virus. A strong relationship was observed between HIV and hepatitis B status and risk behavior. Conclusions. In this study population, receptive anal intercourse and increasing numbers of male partners had the strongest correlation with the prevalence of HIV and hepatitis B virus infection in men. The high level of risk reporting for individuals positive for HIV or hepatitis B suggests that survey participants who engage in risk behaviors were willing to report those behaviors. (Am J Public Health. 1994;84:747-753), People who engage in behaviors that put them at risk for HIV infection appear willing to disclose this information during surveys. A total of 1,446 people between 18 and 54 years old completed a questionnaire about behaviors related to the risk of HIV infection for the Dallas County Household HIV Survey in 1989. Of these, 1,374 also provided a blood sample. Blood samples were analyzed for HIV and hepatitis B infections. Slightly more than 7% of those surveyed were infected with hepatitis B while 0.4% were HIV positive. Estimates of HIV and hepatitis B infection were significantly increased among those considered to be at high-risk for infection. Almost 5% of the men and 20% of the women reported participating in receptive anal intercourse. There was a strong association between HIV status and reports of high-risk behavior. Because these findings are consistent with known patterns of HIV transmission it appears that survey participants are willing to report high-risk behaviors. Responses obtained in this manner can be used to tailor HIV-prevention information to specific groups and areas.