Risk factors for herpes simplex virus type 2 and HIV among women at high risk in northwestern Tanzania: preparing for an HSV-2 intervention trial.
OBJECTIVE
To determine prevalence of and risk factors for herpes simplex virus type 2 (HSV-2) and HIV among women being screened for a randomized, controlled trial of HSV suppressive therapy in northwestern Tanzania.


METHODS
Two thousand seven hundred nineteen female facility workers aged 16 to 35 were interviewed and underwent serological testing for HIV and HSV-2. Factors associated with HSV-2 and HIV in women aged 16 to 24 were examined using logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI).


RESULTS
HSV-2 seroprevalence was 80%, and HIV seroprevalence was 30%. Among women aged 16 to 24, both infections were significantly and independently associated with older age, being a bar worker, working at a truck stop, and having more lifetime sexual partners. HSV-2 infection was also associated with lower socioeconomic status, increased alcohol intake, younger age at first sex, inconsistent condom use, and vaginal douching. There was a strong association between the 2 infections after adjustment for other factors (OR = 4.22, 95% CI: 2.6 to 6.9).


CONCLUSIONS
Female facility workers in northwestern Tanzania are vulnerable to HSV-2 and HIV infections. Programs designed to increase safer sexual behavior and reduce alcohol use could be effective in reducing HSV-2 incidence and, in turn, HIV infection. This is a suitable population for an HSV suppressive therapy trial.
Watson-Jones
Deborah
D
London School of Hygiene and Tropical Medicine, London, England. deborah.watson-jones@lshtm.ac.uk
Weiss
Helen A
HA
Rusizoka
Mary
M
Baisley
Kathy
K
Mugeye
Kokugonza
K
Changalucha
John
J
Everett
Dean
D
Balira
Rebecca
R
Knight
Louise
L
Ross
David
D
Hayes
Richard J
RJ
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000437:Alcoholism; D000914:Antibodies, Viral / Q000097:blood; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology*; D006558:Herpes Genitalis / Q000175:diagnosis / Q000453:epidemiology*; D018258:Herpesvirus 2, Human / Q000276:immunology; D006801:Humans; D016015:Logistic Models; D008487:Medical History Taking; D009790:Occupations; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D013636:Tanzania / Q000453:epidemiology; D044364:Vaginal Douching
D000914:Antibodies, Viral; D015483:HIV Antibodies