Influence of sexual activity on cytomegalovirus seroprevalence in the United States, 1988-1994

Abstract

Background: Sexual and nonsexual transmission of cytomegalovirus (CMV) occurs, but the frequency of sexual transmission in the general population of the United States is unknown.

Methods: Using data from 15- to 44-year-old (n = 7883) participants of the Third National Health and Nutrition Examination Survey (1988-1994), we examined the association between CMV seroprevalence and sexual activity markers. Using logistic regression, we calculated standardized prevalence differences (PDs)-the weighted average CMV prevalence among higher sexual risk groups minus CMV prevalence among the lowest sexual risk group-for each of several sexual activity markers (ever had sex, number of sex partners [lifetime and past year], age at first intercourse, potential years of sexual activity, ever use oral contraceptives, herpes simplex virus type 2 antibody, and a calculated composite marker).

Results: Even after controlling for covariates, we found associations between CMV seroprevalence and sexual activity among non-Hispanic black [all PDs for sexual activity markers were positive and composite PD = 8.5%, 95% confidence interval (CI) = 4.0%-13.1%] and non-Hispanic white women (15 of 18 PDs for sexual activity markers were positive and composite PD = 10.8%, 95% CI = 3.1%-18.5%). We found a borderline significant association among Mexican American women (13 of 18 PDs for sexual activity markers were positive and composite PD = 3.5%, 95% CI = -0.7% to 7.6%). We found little or no association within each racial/ethnic group of men.

Conclusions: Sexual activity measurably influences CMV seroprevalence among women of childbearing age, indicating that congenital CMV prevention messages should include strategies to reduce sexual transmission of CMV among pregnant women.