Prevalence, Change Over Time, and Comparison With U.S. Estimates of Selected Infectious Diseases in Los Angeles County: Findings From the National Health and Nutrition Examination Survey, 1999-2006 and 2007-2014.

Objective-This report compares prevalence of and change over time for five infectious disease outcomes for the Los Angeles County (LAC) and the U.S. populations. The infectious disease outcomes examined are: herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2), any hepatitis B virus (HBV) infection, HBV immunization, and hepatitis A virus (HAV) from infection or immunization, available for 1999-2006 and 2007-2014, as well as any human papillomavirus (HPV) and high-risk HPV infection, available for the 2007-2014 period only. Methods-LAC was sampled in every 2-year cycle of the current National Health and Nutrition Examination Survey, enabling creation of two 8-year samples (1999-2006 and 2007-2014). Demographic differences associated with disease prevalence were examined between LAC and the United States. Changes over time and differences in prevalence, unadjusted, age adjusted, and "fully" adjusted by direct standardization for these demographic variables, were evaluated between the United States and LAC for 2007-2014. Results-Compared with the United States, persons in LAC were more likely to be Mexican American, born outside of the United States, and live below the poverty level. Prevalence varied significantly by demographic subgroup for each outcome in the United States and for some outcomes in LAC. Differences between LAC and the United States existed for some outcomes but varied with adjustment. Over time, prevalence of HSV-1, HSV-2, and HBV infection decreased, and HBV immunization and HAV infection or immunization increased for the U.S. population. The direction of changes over time were mostly similar for LAC, but significance varied.