title: Sexual behaviour and human herpesvirus 8 infection in homosexual men in Australia.
abstract: BACKGROUND
  Human herpesvirus 8 (HHV-8) is a common sexually transmitted agent among homosexual men, but there are few Australian data. We aimed to describe the prevalence and risk factors for seropositivity to HHV-8 in Australian homosexual men.
  
  
  METHODS
  We conducted a prospective cohort study of 179 homosexual men in Sydney Australia in 1992-1998. Detailed data on sexual behaviour was collected annually, and HHV-8 status was determined at the end of the study by an algorithm based on results of an immunofluorescence assay and an enzyme-linked immunoassay to the K8.1 protein of HHV-8. HHV-8 DNA was detected in buffy coats using a nested qualitative PCR.
  
  
  RESULTS
  Data on sexual behaviour in at least three interviews and HHV-8 status were available in 174 (97%) of 179 men who agreed to participate. Of these, 31 (18%) were HHV-8 seropositive, and HHV-8 DNA was detected in 5 (16%) of these. The prevalence of HHV-8 infection was much higher in HIV positive (52%) than HIV negative (11%) men (OR 8.60, 95% CI 3.55-20.86). HHV-8 infection was related to more frequent reporting of unprotected receptive anal sex (OR for most frequent versus least frequent category 3.03, 95% CI 1.01-9.03, P trend 0.02), insertive oro-anal sex (OR for most frequent v. least frequent category 3.02, 95% CI 1.15-7.93, P trend 0.02) and receptive oro-anal sex (OR for most frequent v. least frequent category 3.09, 95% CI 1.11-8.60, P trend 0.05) with casual partners.
  
  
  CONCLUSIONS
  These data are consistent with sexual transmission of HHV-8, but the precise mode of HHV-8 transmission remains unclear. Studies to elucidate the precise mode of sexual transmission of HHV-8 need to focus on potential salivary transmission, and should collect data on the HHV-8 infection and excretion status of the sexual partner.
authors.affiliation: National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Level 2, 376 Victoria Street, Sydney, NSW 2010 Australia. agrulich@nchecr.unsw.edu.au
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Grulich
authors.forename: Philip
authors.initials: P
authors.lastname: Cunningham
authors.forename: Mee-Ling
authors.initials: ML
authors.lastname: Munier
authors.forename: Garrett
authors.initials: G
authors.lastname: Prestage
authors.forename: Janaki
authors.initials: J
authors.lastname: Amin
authors.forename: Clare
authors.initials: C
authors.lastname: Ringland
authors.forename: Denise
authors.initials: D
authors.lastname: Whitby
authors.forename: Susan
authors.initials: S
authors.lastname: Kippax
authors.forename: John M
authors.initials: JM
authors.lastname: Kaldor
authors.forename: William
authors.initials: W
authors.lastname: Rawlinson
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004279:DNA, Viral / Q000097:blood; D006566:Herpesviridae Infections / Q000097:blood / Q000453:epidemiology* / Q000821:virology; D019288:Herpesvirus 8, Human / Q000302:isolation & purification; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009517:New South Wales / Q000453:epidemiology; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D012309:Risk-Taking; D016036:Seroepidemiologic Studies; D047568:Unsafe Sex / Q000706:statistics & numerical data*
chemical_list: D004279:DNA, Viral