Chakraborty P, Norris AH, Huber-Krum S, et al. - Given that for herpes simplex virus type 2 (HSV-2) infection, the HerpeSelect 2 ELISA IgG test is widely used, convenient, and inexpensive, but has lower specificity among populations in Sub-Saharan Africa compared with HSV-2 tests regarded as criterion standards. Researchers here examined unadjusted associations between select demographic and sexual risk factors and HSV-2 serostatus among 248 women partaking in a community-based cohort study in rural Malawi (the Umoyo wa Thanzi project) using multinomial logistic regression accounting for village-level clustering. As specificity improves with increasing the index value cutpoint for a positive result, they coded HSV-2 serostatus in 2 ways: the manufacturer's recommended cutpoints (< 0.9, negative; 0.9–1.1, indeterminate; > 1.1, positive) and modified cutpoints with improved specificity (< 0.9, negative; 0.9–3.5, indeterminate; > 3.5, positive). Further, they examined if correlations between select risk factors and HSV-2 serostatus changed under 2 approaches. In this sample, HSV-2 prevalence was 67% under the manufacturer's cutpoint and 22% under the modified cutpoint. Under both cutpoints, HSV-2–positive serostatus was identified to be correlated with age, household size, number of marriages, and number of pregnancies. Using modified cutpoints, HSV-2 seropositivity was identified to be correlated with current bacterial vaginosis, partner concurrency and unsure about partner concurrency. The only variables significantly associated with indeterminate HSV-2 serostatus using the modified cutpoints were household size, education, and marital status. HSV-2-focused interventions informed by identifying individuals likely to have or acquire HSV-2 must be informed that depending on the adopted cutpoints different target populations may emerge.