The role of herpes simplex virus type 2 and other genital infections in the acquisition of HIV-1 among high-risk women in northern Tanzania.
BACKGROUND
We examined the role of herpes simplex virus type 2 (HSV-2) and other genital infections on human immunodeficiency virus type 1 (HIV-1) incidence in a cohort study conducted between 2002 and 2005 among female bar/hotel workers in Moshi, Tanzania.


METHODS
At baseline and every 3 months thereafter, participants were interviewed, and blood and genital samples were collected. Predictors of HIV-1 incidence were evaluated using a Cox proportional hazards regression model.


RESULTS
Of 845 women who were HIV-1 seronegative at baseline, 689 (81.5%) were monitored in the study for a total of 698.6 person-years at risk (PYARs). The overall HIV-1 incidence was 4.6/100 PYARs (95% confidence interval [CI], 3.0-6.2/100 PYARs), and condom use was very low. After adjustment for other risk factors, the risk of HIV-1 was increased among women with HSV-2 at baseline (hazard ratio [HR], 4.3 [95% CI, 1.5-12.4]) and in those who acquired HSV-2 during the study period (HR, 5.5 [95% CI, 1.2-25.4]). Other independent predictors of HIV-1 were baseline chlamydial infection (HR, 5.2), bacterial vaginosis (HR, 2.1), and the occurrence of genital ulcers (HR, 2.7).


CONCLUSIONS
HSV-2 and other genital infections were the most important risk factors for HIV-1. Control of these infections could help to reduce HIV-1 incidence in this population.
Kapiga
Saidi H
SH
Department of Population and International Health, Harvard School of Public Health, Boston, MA 02115, USA. skapiga@hsph.harvard.edu
Sam
Noel E
NE
Bang
Heejung
H
Ni
Quanhong
Q
Ao
Trong T H
TT
Kiwelu
Ireen
I
Chiduo
Sarah
S
Ndibe
Uzodinma
U
Seage
George
G
Coplan
Paul
P
Shao
John
J
Rosenberg
Zeda F
ZF
Essex
Max
M
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D015497:HIV-1; D006561:Herpes Simplex / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D018258:Herpesvirus 2, Human; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control; D011795:Surveys and Questionnaires; D013636:Tanzania / Q000453:epidemiology