Meta-regression results
The results of univariate and multivariable meta-regression analyses are
summarized in Table 3. We performed two multivariable models, the second
multivariable model replacing the categorical variable of “year of data
collection” in the first multivariable model with another temporal
variable of “year of publication”.
The first multivariable model explained 47.7% of the variation in
seroprevalence (Table 3). Compared to general populations, FSWs had the
highest HSV-2 seroprevalence with an adjusted risk ratio (ARR) of 1.66
(95% CI: 1.58-1.75), followed by drug users (ARR=1.53, 95% CI:
1.39-1.70), PLWH and HIV-negative individual in HIV discordant couples
(ARR=1.22, 95% CI: 1.12-1.32), STI clinic attendees (ARR=1.20, 95%CI:
1.15-1.25), intermediate-risk populations (ARR=1.13, 95% CI: 1.05-1.22)
and MSM/MSWs (ARR=1.09, 95% CI: 1.03-1.16).
Compared to those aged <20 years, HSV-2 seropositivity
increased with age and was highest in those aged ≥60 years (ARR=1.22,
95% CI: 1.11-1.36). People living in the Northeast have the highest
risk of HSV-2 (ARR=1.30, 95% CI: 1.21-1.40) than those living in the
North, followed by the Southwest (ARR=1.10, 95% CI: 1.04-1.16) and
Central-southern regions (ARR=1.10, 95% CI: 1.04-1.16). Men have a
similar HSV-2 seroprevalence as women (ARR=0.96, 95% CI: 0.92-1.01).
Studies that used PCR as an assay reported lower HSV-2 seroprevalence
than those using ELISA.
Studies with larger sample sizes and non-probability sampling reported
lower seroprevalence. Studies with lower response rates reported higher
seroprevalence. Compared to data collected before 2000, data collected
during 2001-2010 (ARR=0.88, 95% CI: 0.83-0.94) and after 2010
(ARR=0.91, 95% CI: 0.85-0.96) had lower HSV-2 seroprevalence.
The second model explained 45.7% of the variation in HSV-2
seroprevalence, yielding similar results to the first model. The
seroprevalence did not vary by year of publication (Table 3 ).