{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T08:00:32Z","timestamp":1793347232872,"version":"4.5.0"},"reference-count":25,"publisher":"BMJ","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sex Transm Infect"],"published-print":{"date-parts":[[2003,12]]},"abstract":"<jats:p>\n                  <jats:bold>Objectives:<\/jats:bold> 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.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Methods:<\/jats:bold> 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.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Results:<\/jats:bold> Overall age adjusted HSV-2 seroprevalence was 38.5% (95% CI, 37.5 to 39.5), and it was strongly associated with increasing age (p<jats:sub>Trend&lt;0.0001<\/jats:sub>), 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\u200a=\u200a7.6 95% CI, 4.7 to 12.4 p<jats:sub>Trend&lt;0.0001<\/jats:sub>). 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).<\/jats:p>\n               <jats:p>\n                  <jats:bold>Conclusions:<\/jats:bold> 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.<\/jats:p>","DOI":"10.1136\/sti.79.6.460","type":"journal-article","created":{"date-parts":[[2003,12,8]],"date-time":"2003-12-08T12:23:02Z","timestamp":1070886182000},"page":"460-465","source":"Crossref","is-referenced-by-count":12,"title":["A population based study of herpes simplex virus 2 seroprevalence in rural Costa Rica"],"prefix":"10.1136","volume":"79","author":[{"given":"A C","family":"Rodr\u00edguez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P E","family":"Castle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J 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