title: Association of herpes simplex virus type 2 infection and syphilis with human immunodeficiency virus infection among men who have sex with men in Peru.
abstract: BACKGROUND
  We evaluated associations between human immunodeficiency virus (HIV) infection, herpes simplex virus type 2 (HSV-2) infection, and syphilis among men who have sex with men (MSM) in Peru.
  
  
  METHODS
  A surveillance survey of 3280 MSM was conducted; sexual behavior was assessed with a structured computer-assisted self-interview, and serum antibody testing was performed for HIV, HSV-2, and Treponema pallidum.
  
  
  RESULTS
  HIV, HSV-2, and syphilis seroprevalences of 13.9%, 46.3%, and 13.4% were detected, respectively. HSV-2 seroprevalence was twice as high in HIV-infected subjects (80.5%) than it was in HIV-uninfected subjects (40.8%) (P < .01), and HSV-2 seropositivity (adjusted odds ratio [AOR], 5.66) was found to be strongly associated with HIV infection. In addition, homosexual self-definition (AOR, 3.12), exchange of sex for money (AOR, 1.61), unprotected sex (no condom) (AOR, 2.81), history of sex work (AOR, 1.89), oral receptive sex (AOR, 1.43), and cocaine use before/during sex (AOR, 2.53) within the preceding 6 months, as well as such sexually transmitted infections (STIs) and STI syndromes as proctitis (AOR, 2.80), genital ulcer disease (GUD) (AOR, 2.06), prior syphilis (AOR, 2.64), genital warts (AOR, 1.70), and self-reported STIs within the preceding 6 months (AOR, 1.61), were also found to be significant predictors of HIV infection.
  
  
  CONCLUSIONS
  We found a strong association between HSV-2 seropositivity and HIV infection. Intervention measures against GUD due to HSV-2 infection and syphilis, such as routine testing, early detection, HSV-2 suppressive treatment, and condom distribution, need to be enhanced as part of STI prevention strategies at a national level to effectively reduce HIV infection among MSM in Peru.
authors.affiliation: Asociacion Civil Impacta Salud y Educacion, Ministry of Health of Peru, Lima, Peru.
authors.forename: Javier R
authors.initials: JR
authors.lastname: Lama
authors.forename: Aldo
authors.initials: A
authors.lastname: Lucchetti
authors.forename: Luis
authors.initials: L
authors.lastname: Suarez
authors.forename: Victor A
authors.initials: VA
authors.lastname: Laguna-Torres
authors.forename: Juan V
authors.initials: JV
authors.lastname: Guanira
authors.forename: Monica
authors.initials: M
authors.lastname: Pun
authors.forename: Silvia M
authors.initials: SM
authors.lastname: Montano
authors.forename: Connie L
authors.initials: CL
authors.lastname: Celum
authors.forename: Jean K
authors.initials: JK
authors.lastname: Carr
authors.forename: Jorge
authors.initials: J
authors.lastname: Sanchez
authors.forename: Christian T
authors.initials: CT
authors.lastname: Bautista
authors.forename: Jose L
authors.initials: JL
authors.lastname: Sanchez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D019970:Cocaine-Related Disorders / Q000150:complications; D003218:Condylomata Acuminata / Q000150:complications; D015658:HIV Infections / Q000150:complications*; D006558:Herpes Genitalis / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D018258:Herpesvirus 2, Human; D018451:Homosexuality, Male; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010568:Peru; D011349:Proctitis / Q000150:complications; D016036:Seroepidemiologic Studies; D011477:Sex Work / Q000706:statistics & numerical data; D012725:Sexual Behavior / Q000706:statistics & numerical data; D013223:Statistics as Topic; D013587:Syphilis / Q000150:complications* / Q000453:epidemiology; D014210:Treponema pallidum; D047568:Unsafe Sex / Q000706:statistics & numerical data
chemical_list: D000907:Antibodies, Bacterial; D000914:Antibodies, Viral