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By Kevin Fenton, M.D.

Director, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention

Centers for Disease Control and Prevention

In March, CDC announced the findings from a recent analysis – one in six Americans ages 14-49 is infected with herpes simplex virus type 2 (HSV-2), the virus that causes genital herpes.

This statistic alone is staggering, but even more troubling are the numbers among African Americans. The analysis showed that 39 percent of our community is infected with genital herpes, and – even worse – that 48 percent of African-American women are infected with the life-long virus.

The news – that black women are so dramatically affected by this infection – for many was shocking, alarming, even painful, and understandably so.

Unfortunately, this latest news was not actually new. According to several CDC analyses of the National Health and Nutrition Examination Survey (NHANES) – the source of the data – the prevalence of genital herpes for black women has remained unacceptably high, at about 50 percent, for more than two decades.

NHANES has been considered one of the most reliable sources of data on American health since the 1960s. A nationally representative household survey, it is used widely to monitor a range of public health issues in the United States, including heart disease and diabetes.

While CDC stands firmly behind these statistics and the methodology used to develop them, the alarm felt across black communities in the wake of this announcement served as a reminder of how much work is left to be done to protect the health of our friends and families. For the public health community, it challenges us to do more. We must continue to look beyond the statistics, to better understand the impact of these stark numbers and those of other sexually transmitted infections (STIs) on the communities most affected. We must also continue to help lead and engage the dialogue needed to address these issues.

For those of us in the black community, these findings force us to recognize that we can no longer bury our heads in the sand about the impact of sexually transmitted infections on us all. The numbers are real and the impact is far-reaching. Minimizing the effect of these infections in our communities does us all a disservice.

If we are to stop the spread of STIs in our communities we have to face the truth about their impact.

Some harsh realities of genital herpes:

• While often asymptomatic, HSV-2 is a lifelong and incurable infection that can cause recurrent and painful genital sores. It also increases the likelihood of acquiring and transmitting HIV. The fact that HSV-2 can double or triple your likelihood of acquiring HIV is a stark reminder that we cannot afford to ignore this disease.

• Higher rates of HSV-2 among African Americans are not necessarily a result of greater individual sexual risk behavior. Because the prevalence of HSV-2 among black men and women is higher than that of any other race or ethnicity, and because African Americans are more likely to have sexual relations with others of the same race/ethnicity, African Americans face a greater risk of being exposed to the infection with any given sexual encounter. In addition, a wide range of socio-economic issues, from poverty and drug use to stigma and discrimination, all contribute to the high levels of HSV-2 in black communities.

• Women, in general, are more biologically susceptible to acquiring HSV-2 infection than men. Thus, African American women are particularly vulnerable to HSV-2, due to both biological factors and the already high community prevalence of disease.

• Black men are also severely affected by this infection. Almost 30 percent of African American men are infected with HSV-2 – a prevalence rate higher than that of men of any other race or ethnicity.

• More than 80 percent of individuals with HSV-2 don’t know that they are infected. Despite most people having no or only minimal symptoms, once infected with HSV-2 you can transmit the virus to others. As a result, the majority of those who transmit the virus are passing the infection on to others without knowing it.

Not knowing that you have HSV-2 or genital herpes can have tragic consequences. This was the case of one young lady who called in to the Big Tigger Morning Show during my recent appearance on that radio program.

She shared with the audience that because she had no symptoms, she never knew she had genital herpes until the day she gave birth to her first child. Doctors presented her with the devastating news that she had unknowingly passed the virus to her newborn, with far-reaching health consequences for the baby. She was shocked to learn too late that a sexually transmitted infection could do such harm to her own child. Sadly, her story is not unique and is repeated across the nation throughout our communities.

There are, however, tangible steps each of us can take to prevent the spread of this infection.

• Talk to your doctor – if you have HSV-2 ask about treatment that can help you manage the disease and reduce your chances of transmitting it to others.

• Get tested – if you have herpes symptoms or a sexual partner with the infection ask your doctor for a blood test for HSV-2. To locate an STD testing site near you, please visit http://www.findstdtest.org.

• Use a condom – because genital herpes is so prevalent, it’s important to use condoms correctly and consistently with all your partners to reduce your risk of becoming infected.

• Talk to your partners – ask them about their status and avoid sex if you or your partner has visible lesions or sores.

Finally, it is critical that we look at this recent analysis not simply as a snapshot of one prevalent disease in the black community. It should serve as a wake-up call to the continuing, severe disparities affecting the sexual health of black women and men in this country. Many STIs disproportionately impact black women. Left untreated, these infections can result in ectopic pregnancy, pelvic inflammatory disease, infertility and infant death.

However, these numbers remind us that STI prevention cannot be viewed as wholly a woman’s responsibility – but as a shared commitment between men and women of all ages to use prevention strategies every time they have sex. Similarly, STI prevention programs must target men and women if they are to be effective.

So while this recent analysis may be alarming, it emphasizes that we cannot afford to be complacent about this infection or STIs in general. We each must do our part to educate and protect ourselves and our loved ones, and to face the harsh realities of this disease head on. The health of the men, women, and children in our community demands nothing less.

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