title: No evidence of sexual transmission of Kaposi's sarcoma herpes virus in a heterosexual South African population.
abstract: BACKGROUND
  The transmission of Kaposi's sarcoma herpes virus (KSHV) in men who have sex with men is clearly associated with sexual risk factors, but evidence of heterosexual transmission of KSHV is conflicting.
  
  
  METHODS
  Sera were obtained from 2103 South African individuals (862 miners, 95 sex workers, 731 female and 415 male township residents; mean age 33.2 years; +/- 10.1). All sera were tested for antibodies to KSHV lytic K8.1 and latent Orf73, HIV, gonococcus, herpes simplex virus type 2 (HSV-2), syphilis and chlamydia. Information on social, demographic and high-risk sexual behavior was linked to laboratory data, to evaluate risk factors, expressed as odds ratios (95% confidence interval) for KSHV.
  
  
  RESULTS
  Overall KSHV and HIV prevalences were 47.5 and 40%, respectively (P = 0.43). The risk of HIV infection was highest in sex workers then female residents and miners, compared with male residents (P < 0.001). HSV-2 infection was highly prevalent (66%) and lower, but still substantial, prevalences (6-8%) were observed for other sexually transmitted infections (STI). No significant difference in KSHV infection was observed among the residential groups (P > 0.05). KSHV was not associated with any of the STI or any measures of sexual behavior (P > 0.05).
  
  
  CONCLUSIONS
  The pattern of HIV and STI in sex workers suggests high rates of high-risk sexual behavior in this population. The lack of association with high-risk sexual behavior, particularly in sex workers, and with any markers of STI strongly suggest that the sexual mode does not play a significant role in KSHV transmission in this South African population.
authors.affiliation: Clinical HIV Research Unit, Department of Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
authors.forename: Babatyi I
authors.initials: BI
authors.lastname: Malope
authors.forename: Patrick
authors.initials: P
authors.lastname: MacPhail
authors.forename: Georgina
authors.initials: G
authors.lastname: Mbisa
authors.forename: Catherine
authors.initials: C
authors.lastname: MacPhail
authors.forename: Lara
authors.initials: L
authors.lastname: Stein
authors.forename: Edith M
authors.initials: EM
authors.lastname: Ratshikhopha
authors.forename: Lewis
authors.initials: L
authors.lastname: Ndhlovu
authors.forename: Freddy
authors.initials: F
authors.lastname: Sitas
authors.forename: Denise
authors.initials: D
authors.lastname: Whitby
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D020010:Heterosexuality / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012514:Sarcoma, Kaposi / Q000453:epidemiology*; D011477:Sex Work / Q000706:statistics & numerical data*; D015229:Sexually Transmitted Diseases, Viral / Q000453:epidemiology / Q000635:transmission*; D013019:South Africa / Q000453:epidemiology; D047568:Unsafe Sex