Oral Versus Vaginal Sex Among Adolescents: Perceptions, Attitudes, and Behavior

Halpern‐Felsher, Bonnie; Cornell, Jodi L.; Kropp, R.; Tschann, Jeanne M.

doi:10.1542/peds.2004-2108

Cited by 258 publications

(225 citation statements)

References 28 publications

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“…Oral sex is viewed as less risky and often this is not explored in the sexual history. [11] Physicians usually communicate ineffectively and are unclear when obtaining a sexual history; hence, risky behaviours are often missed. Sexual reproductive healthcare is central to medical care of adolescents and should include screening for STIs, risk-reduction counselling and contraception counselling.…”

Section: Adolescence and Hiv Infectionmentioning

confidence: 99%

Adolescent HIV treatment issues in South Africa

Dawood

2015

S Afr Med J

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Section: Adolescence and Hiv Infectionmentioning

confidence: 99%

Adolescent HIV treatment issues in South Africa

Dawood

2015

S Afr Med J

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“…15,21,22 The increase is thought to be the result of both less frequent acquisition of HSV-1 in childhood and more frequent oral-genital contact at the initiation of sexual activity. 35,36 Not surprisingly, the increase in genital HSV-1 infection has resulted in an increase in neonatal HSV-1 in proportions that meet or exceed that caused by HSV-2. HSV-1 caused 63% of neonatal HSV in Canada 28 and 50% in Seattle.…”

Section: Increasing Importance Of Neonatal Hsv-1mentioning

confidence: 99%

Prevention of neonatal herpes

Gardella

Brown

2010

BJOG

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Neonatal herpes can occur when the neonate is exposed to herpes simplex virus in the maternal genital tract during labour. Attack rates are highest when the mother has a newly acquired infection and, therefore, does not have antibodies to protect the neonate. Even with early therapy, there is significant morbidity and mortality associated with neonatal herpes, suggesting that preventing neonatal herpes simplex virus exposure or early recognition of exposure is important. The incidence of neonatal herpes has not declined despite national guidelines for prevention. This suggests that the prevention guidelines need to be re-addressed.Keywords Herpes, neonate, prevention.Please cite this paper as: Gardella C, Brown Z. Prevention of neonatal herpes. BJOG 2011;118:187-192. Epidemiology of genital herpesBased on serological data from a large National Health and Nutrition Examination Survey (NHANES), 22% of pregnant women in the USA are infected with herpes simplex virus 2 (HSV-2), 63% are HSV-1 seropositive, 13% have both HSV-1 and HSV-2, and 28% are seronegative. 1 In the general population, for the first time since the 1976 inception of NHANES, the seroprevalence of HSV-2 has decreased; overall, the age-adjusted HSV-2 seroprevalence was 17% in 1999-2004, compared with 21% in 1988-94, a relative decrease of 19% between the two study periods. Among those infected with HSV-2, the percentage who reported being diagnosed was 14.3% in 1999-2004 and 9.9% in 1988-94, suggesting that more providers are aware of genital herpes, and able to make appropriate diagnoses. 2 However, the vast majority of people infected with HSV-2 remain undiagnosed and, therefore, untreated and able to spread the infection. Between 75% and 90% of HSV-2-infected people are not aware of having the infection. [3][4][5][6] This is important because most sexual transmission of HSV occurs during episodes of subclinical reactivation among persons with unrecognized infection. 4,7-10 Virtually all HSV-2 seropositive people have intermittent shedding from the genital mucosa, and most have mild (and hence unrecognized and undiagnosed) disease. 5 In the absence of symptoms, HSV-2 can be detected in the genital tract, by viral culture, on 3% of days for the first year after initial infection, then on 1% of days for the next 2 years. HSV-2 DNA can be detected by polymerase chain reaction testing 15-20% of days. 11,12 Recent data suggest that HSV reactivation may occur much more frequently than previously understood, and may be characterised by frequent short bursts of viral shedding that do not correlate with symptoms. 13 As HSV-2 seroprevalence decreased, HSV-1 seroprevalence in the USA increased to 62% in 1988-94 from 57.7% in 1999-2004. 2 Among persons infected with HSV-1 but not HSV-2, a higher percentage reported a diagnosis of genital herpes in 1999-2004 compared with 1988-94 (1.8% versus 0.4%). 2 HSV-1 has emerged as a major cause of genital herpes among college-age populations, in which up to 80% of new cases of genital HSV were caused by HSV-1. [14][1...

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“…Fellatio and cunnilingus are reported to be more common in younger age groups (15), being perceived as safer than intercourse and as a means of averting pregnancy (16). Such a change would favour the transmission of HSV1 in this population.…”

Section: Discussionmentioning

confidence: 97%

Herpes Simplex Virus Type 1 is the Leading Cause of Genital Herpes in New Brunswick

Garceau

Leblanc

Thibault

et al. 2012

Canadian Journal of Infectious Diseases and Medical Microbiolog

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INTRoDuCTIoN:Little is known about the role of herpes simplex virus (HSV) type 1 (HSV1) in the epidemiology of genital herpes in Canada. Data on herpes viral cultures for two consecutive years obtained from L'Hôpital Dr GL Dumont, which performs all the viral culture testing in New Brunswick, were reviewed. It was hypothesized that HSV1 was the main cause of genital herpes in New Brunswick. MeTHoDs: Samples of genital origin sent to the laboratory for HSV culture testing between July 2006 and June 2008 were analyzed. Samples from an unspecified or a nongenital source were excluded from analysis. Multiple positive samples collected from the same patient were pooled into a single sample. ResuLTs: HSV was isolated from 764 different patients. HSV1 was isolated in 62.6% of patients (male, 55%; female, 63.8%). HSV1 was isolated in 73.2% of patients 10 to 39 years of age and in 32% of patients ≥40 years of age. The difference in rates of HSV1 infection between the 10 to 39 years of age group and the ≥40 years of age group was statistically significant (P<0.001 [χ 2 ]). In a similar Canadian study performed in Nova Scotia, HSV1 was recovered in 53.7% of positive cultures (male, 36.7%; female, 58.1%). The rates of HSV1 infection reported by this study and the present study were significantly different (P<0.001 [χ 2 ] for male, P=0.012 for female). CoNCLusIoN: In New Brunswick, HSV1 is the dominant type of HSV isolated in samples collected from a genital site. Significant rate differences were demonstrated between the groups 10 to 39 years of age and ≥40 years of age. (1), but either HSV type 1 (HSV1) or HSV2 may be the cause (2). The relative role of HSV1 in herpes simplex genital infections varies from 3.9% to 78% (3,4). Most studies have relied on herpes simplex type-specific serology in estimating the significance of HSV2 in causing sexually transmitted infections. However, HSV1 is commonly acquired as an orolabial infection, so antibodies against it cannot be conclusively linked to genital infections. Using methods such as viral culture or molecular assays, it is possible to ascertain the role of HSV1 in causing genital ulcers. In our experience, many samples of genital origin tested in our laboratory grew HSV1. Given that our laboratory has tested all samples from New Brunswick for HSV since 2006 and given the sparsity of Canadian data, we decided to analyze two years of sample results (July 2006 to June 2008, hypothesizing that HSV1 would be the dominant type of HSV identified in those samples. MeTHoDsThere are no privately operated laboratories in New Brunswick. L'Hôpital Dr GL Dumont, located in southeast New Brunswick, is the only viral testing laboratory in the province, and has provided HSV culture services since 1992. New Brunswick laboratories ceased referring samples for HSV culture outside the province during the spring of 2006, when New Brunswick had a population of 748,000 (5). A review of the number of samples referred from other laboratories before and after the spring of 2006 confirmed that all sam...

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Oral Versus Vaginal Sex Among Adolescents: Perceptions, Attitudes, and Behavior

Cited by 258 publications

References 28 publications

Adolescent HIV treatment issues in South Africa

Adolescent HIV treatment issues in South Africa

Prevention of neonatal herpes

Herpes Simplex Virus Type 1 is the Leading Cause of Genital Herpes in New Brunswick

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