Herpes simplex virus type 2 infection among young uncircumcised men in Kisumu, Kenya.
OBJECTIVE
To identify factors associated with herpes simplex virus type 2 (HSV-2) infection among men aged 18-24 in Kisumu, Kenya.


METHODS
Baseline data from a randomised trial of male circumcision were analysed. Participants were interviewed for sociodemographic and behavioural risks. The outcome was HSV-2 by antibody status. Risk factors were considered singly and in combination through logistic regression models.


RESULTS
Among 2771 uncircumcised men, 766 (27.6%; 95% confidence interval (CI) 26.0% to 29.3%) tested antibody positive for HSV-2. The median age at first sex was 16 years, and the median number of lifetime sexual partners was four. HSV-2 seroprevalence increased from 19% among 18-year-olds to 43% among 24-year-olds (p<0.001). In multivariable analysis, statistically significant risks for infection were increasing age (adjusted odds ratio (AOR) = 1.22-2.58), being married or having a live-in female partner (AOR = 1.80; 95% CI 1.28 to 2.53), preferring "dry" sex (AOR = 1.39; 95% CI 1.14 to 1.69), reported penile cuts or abrasions during sex (AOR = 1.58; 95% CI 1.32 to 1.91), increasing lifetime sex partners (multiple response categories; AORs ranging from 1.65 to 1.97), and non-student occupation (multiple response categories; AORs ranging from 1.44 to 1.93). Risk decreased with reported condom used at last sex (AOR = 0.82; 95% CI 0.68 to 0.99).


CONCLUSIONS
Primary prevention efforts should be initiated at an early age. The same behavioural interventions used currently for HIV prevention-abstinence, reducing the number of sex partners and increasing condom use-should be effective for HSV-2 prevention.
Mehta
S D
SD
Department of Epidemiology and Biostatistics, University of Illinois Chicago School of Public Health, Illinois, USA. supriyad@uic.edu
Moses
S
S
Agot
K
K
Agingu
W
W
Parker
C
C
Ndinya-Achola
J O
JO
Bailey
R C
RC
D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D002944:Circumcision, Male; D017280:Condoms / Q000706:statistics & numerical data; D004812:Epidemiologic Methods; D006558:Herpes Genitalis / Q000175:diagnosis / Q000453:epidemiology*; D018258:Herpesvirus 2, Human / Q000276:immunology*; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D015995:Prevalence
D000914:Antibodies, Viral