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Therefore, the purpose of this study was to examine HSV\u20102 seroprevalence in a sample of drug users in rural Appalachia. Rural Appalachian individuals age 18 or older reporting non\u2010medical use of prescription opioids, heroin, crack\/cocaine, or methamphetamine in the past 6 months (n\u2009=\u2009499) were included. Behavioral, demographic, and sexual network data were collected using interviewer\u2010administered questionnaires. Participants\u2019 serum was tested for HSV\u20102 antibodies using the Biokit rapid test (Lexington, MA). The estimated population seroprevalence of HSV\u20102 was 14.4% (95%CI: 9.6\u201319.4%). Only 8.8% were aware of being HSV\u20102+, and unprotected sex was reported in 80% of serodiscordant sexual relationships. In a multivariate model, female gender, age, older age at first oral sex, and frequency of unprotected sex in the sexual network were independently associated with HSV\u20102 seropositivity. Despite lower seroprevalence than that reported in similar studies of substance abusers, targeted interventions to reduce sexual risk behavior are warranted in this underserved population. Network\u2010informed approaches with particular focus on women, older individuals, and those engaging in frequent unprotected sex are recommended. <jats:bold><jats:italic>J. Med. Virol. 88:512\u2013520, 2016<\/jats:italic>.<\/jats:bold> \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmv.24358","type":"journal-article","created":{"date-parts":[[2015,8,19]],"date-time":"2015-08-19T23:45:28Z","timestamp":1440027928000},"page":"512-520","source":"Crossref","is-referenced-by-count":7,"title":["Correlates to seroprevalent herpes simplex virus type 2 among rural Appalachian drug users"],"prefix":"10.1002","volume":"88","author":[{"given":"Dustin B.","family":"Stephens","sequence":"first","affiliation":[{"name":"Department of Behavioral Science University of Kentucky College of Medicine Lexington Kentucky"},{"name":"Center on Drug and Alcohol Research University of Kentucky College of Medicine Lexington Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"April M.","family":"Young","sequence":"additional","affiliation":[{"name":"Center on Drug and Alcohol Research University of Kentucky College of Medicine Lexington Kentucky"},{"name":"Department of Epidemiology University of Kentucky College of Public Health Lexington Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ursula L.","family":"Mullins","sequence":"additional","affiliation":[{"name":"Center on Drug and Alcohol Research University of Kentucky College of Medicine Lexington Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer R.","family":"Havens","sequence":"additional","affiliation":[{"name":"Department of Behavioral Science University of Kentucky College of Medicine Lexington Kentucky"},{"name":"Center on Drug and Alcohol Research University of Kentucky College of Medicine Lexington Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,8,27]]},"reference":[{"key":"e_1_2_5_2_1","unstructured":"Appalachian Regional Commission.2011. 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