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Genetic and Biological Risk Factors Genetic and biological contributors to escalation risk include: Twin and adoption studies consistently show that 50 to 70% of individual vulnerability to substance use disorder is attributable to genetic factors, including polymorphisms in dopamine receptor genes (DRD2, DRD4), serotonin transporter genes (SLC6A4), and opioid receptor genes (OPRM1)

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Daily suppressive antivirals reduce viral shedding and, per the CDC STI Treatment Guidelines, substantially reduce transmission risk in serodiscordant couples (one partner HSV-positive, the other HSV-negative)