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Human alphaherpesvirus 2 (HSV-2) among female sex workers from Brazil: cross-sectional study using respondent-driven sampling
  1. Lyana Rodrigues Pinto Lima1,
  2. Nathália Alves Araujo Almeida1,
  3. Marco Aurélio Pereira Horta2,
  4. Vinicius S Belo3,
  5. Alexandre Santos da Silva1,
  6. Gina Jonasson Mousquer Capelin4,
  7. Fernanda Rodas Pires Fernandes4,
  8. Marco Antonio Moreira Puga4,
  9. Grazielli Rocha de Rezende4,
  10. Tayana Serpa Ortiz Tanaka4,
  11. Lisie Souza Castro4,
  12. Ana Rita Coimbra Motta-Castro4,5,
  13. Vanessa Salete de Paula1
  1. 1Laboratory of Molecular Virology, Oswaldo Cruz Institute- FIOCRUZ, Rio de Janeiro, Rio de Janeiro, Brazil
  2. 2Flavivirus Laboratory (LABFLA), Oswaldo Cruz Institute - FIOCRUZ, Rio de Janeiro, Rio de Janeiro, Brazil
  3. 3Departamento de Endemias Samuel Pessoa, ENSP/ FIOCRUZ, Rio de Janeiro, Rio de Janeiro, Brazil
  4. 4Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
  5. 5Fiocruz Mato Grosso do Sul, Mato Grosso do Sul, Mato Grosso do Sul, Brazil
  1. Correspondence to Dr Vanessa Salete de Paula, Laboratorio de Virologia Molecular, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil; vdepaula{at}


Objective Female sex workers (FSWs) are vulnerable to human alphaherpesvirus 2 (HSV-2) infection due to their high numbers of sexual partners. The objective of this study was to evaluate the seroprevalence and risk behaviours associated with HSV-2.

Methods A cross-sectional study was conducted in Mato Grosso do Sul, Brazil. A total of 376 FSWs were recruited by respondent-driven sampling (RDS) methodology and answered an epidemiological questionnaire. Blood samples were collected to test for HSV-2 antibodies using commercial ELISA and for HSV-2 DNA using real-time PCR.

Results The seropositivity was 47.3% (178/376) for HSV-2 IgG and 10.1% (38/376) for HSV-2 IgM. HSV-2 viraemia was detected in two infected FSWs with primary infections. In bivariate and multivariate analyses, the OR for HSV-2 IgG increased with age (OR=2.53–7.90, OR=2.66–6.37) and the number of sexual partners (OR=2.30–3.25). On the other hand, daily alcohol consumption (OR=0.10) and the use of condoms during the last intercourse (OR=0.47) were protective factors against HSV-2 acquisition.

Conclusion Despite the impact of FSWs in public health policies with the dissemination of sexually transmitted infections, there have been few studies performed regarding the prevalence of HSV-2 in Brazil, making it difficult to implement any control or preventative measures. The results produced here using an RDS methodology demonstrated a high prevalence, risk behaviours and primary infection among the FSWs. These results reinforce the need to implement control and preventative measures for HSV-2 infection in this population.

  • herpes
  • sexual behaviour
  • virology
  • women

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  • Handling editor Francesca Ceccherini-Silberstein

  • Contributors LRPL, ASdS, GJM, FRPF, MP, GR, TT, LC, ARCM-C and VSdP were responsible for the study design, field logistics and sampling. LRPL, MAH and VSdP were major contributors in writing the manuscript. NAAA and LRPL performed the diagnostic tests. MAH and VSdP analysed and interpreted the data. All authors read and approved the final manuscript.

  • Funding This work was supported by Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (grants E-26/110.311/2014) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval was obtained from the authors’ affiliated institutional review board (The Oswaldo Cruz Foundation Ethics Committee, number 895.159/CAEE:28183314.7.0000.5248). All women provided written informed consent to participate in this study, and no identifying information was collected.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article.