Trichomoniasis in womenattending an antiretroviral clinic in South Africa (original) (raw)
2014, International Journal of Infectious Diseases
Background: Men with high-risk sexual behavior are important drivers of HIV/STIs in the general population. Prevention of HIV/STIs among such men could potentially reduce these infections among women-who bear the greatest HIV/STIs disease burden. HSV-2 infection has been shown to be strongly associated with HIV infections. We sought to estimate the incidence of HSV-2 infection among fishermen. Methods & Materials: Three hundred fishermen were recruited and followed-up every 3 months for 1 year. Specimen for HIV, HSV-2 serology and data on structured demographic questionnaire were collected at baseline and exit. Results: The fishermen had a mean age of 28 years and 76% were married. A significant number of men; 183 (61%) P < 0.01 and 118 (39%) P < 0.05, never used condoms with their frequent sexual partners and new sexual partners respectively. Baseline HSV-2 prevalence was 56.3% and married men were 3 times more likely to have HSV-2 infections compared to single (never married) men adjOR 3.2(95% CI; 1.8-5.5), P < 0.001. HIV positive men were twice more likely to be co-infected with HSV-2 compared to HIV negative men adjOR 2.2(95% CI; 1.2-4.2). At baseline, men who reported only one sexual partner in the last one month were less likely to have HSV-2 infections compared to those who reported multiple sexual partners for the same period adjOR 0.09(95% CI; 0.01-0.74). The annual HSV-2 incidence was 23.6%. HSV-2 negative men reporting a casual partner as their most recent sexual partner at baseline had increased risk of HSV-2 acquisition adjRR 6.7(95% CI; 2.4-18.1). Those reporting consistent condom use of over 75% at baseline had reduced risk of acquiring HSV-2 adjRR 0.12(95% CI; 0.03-0.54) P < 0.01, whereas those who reported no condom use (0% usage) had increased risk of acquiring HSV-2 adjRR 3.2(95% CI; 1.3-7.9), P < 0.01. Multiple number of sexual partners in the past 1 year was strongly associated with incident HSV-2 infection, P < 0.01. Conclusion: Fishermen comprise a young sexually-high-risk population, with high HSV-2 incidence and prevalence. Low condom use coupled with concurrent multiple sexual partnerships predispose fishermen to HSV-2 infections.
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Advances in Infectious Diseases, 2014
Background: Herpes simplex virus Type 2 (HSV-2) has been associated with HIV infection. More recently, HSV-2 incidence has been linked to HIV acquisition. A few studies have suggested that the fishing communities have a high HSV-2 prevalence but there is limited knowledge on HSV-2 incidence and associated risk factors among fishermen. Methods: Three hundred fishermen were consented, and evaluated for baseline HSV-2 serology status and again after 12 months among those negative at baseline. Sexual behavior and socio-demographic data were collected at enrolment and exit visits using a structured questionnaire. Baseline HIV serology and Human papillomavirus (HPV) DNA genotyping were also performed. Multivariate logistic regression was used to determine independent factors associated with HSV-2 acquisition. Results: Baseline HSV-2 prevalence was 56.3% (95% CI: 50.7-62.0). Factors associated with HSV-2 prevalence were, older age (aOR = 1.96; 95% CI: 1.16-2.85), history of STI (aOR 2.12; 95% CI: 1.19-3.91), infection with HIV (aOR 2.22; 95% CI: 1.17-4.22), ever married (aOR = 3.80; 95% CI: 1.42-11.90), most recent sexual act with sex worker/casual partner (OR= 3.56; 95% CI: 1.49-8.62) and inconsistent condom use with new sexual partner (aOR = 6.34; 95% CI: 2.24-13.04). The HSV-2 incidence was 23.6 (95% CI = 15.4-31.8)/100 pyr. Infection with persistent high-risk (HR) HPV (aIRR = 3.35; 95% CI: 1.21-11.37), multiple (≥2) partners in 12 months prior to study participation (aIRR = 4.77; 95% CI: 1.12-11.38), inconsistent condom use with new partner (aIRR =2.53; 95% CI: 1.12-7.38) and most recent sexual act with sex worker/casual partner (OR = 3.03; 95% CI: 1.17-8.58) were independent risk factors for HSV-2 acquisition. Conclusion: The incidence of HSV-2 is very high R. O. Ondondo et al. 102 among fishermen. It is associated with persistent HR HPV infection and high-risk sexual behavior. Intervention strategies targeting these men with high risk sexual behavior are urgently needed to stop new HSV-2 acquisition and subsequently prevent HIV infection.
How safe is safer sex? High levels of HSV-1 and HSV-2 in female sex workers in London
Epidemiology and Infection, 2006
Female sex workers in Europe have low levels of sexually transmitted infections, attributable to condom use. The aim of this paper is to describe the seroepidemiology of HSV-1 and HSV-2 in female sex workers in London by using a 15-year prospective study of 453 sex workers. The seroprevalence of HSV-1 was 74·4% and independently associated with birth in a ‘transitional country’ (OR 5·4, 95% CI 1·61–18·20). The seroprevalence of HSV-2 was 60% and declined over time; it was also independently associated with time in sex work (OR 2·12, 95% CI 1·23–3·65) and birth in a ‘developing country’ (OR 2·95, 95% CI 1·34–6·48). We show that a cohort of sex workers with extensive condom use and little known sexually transmitted infection have high levels of HSV-1 and HSV-2 infection, suggesting that condoms may not be universally protective. Sex workers are candidates for HSV vaccine efficacy or intervention studies.
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