title: High prevalent and incident HIV-1 and herpes simplex virus 2 infection among male migrant and non-migrant sugar farm workers in Zambia.
abstract: BACKGROUND
  More insight is needed regarding risk factors for prevalent and incident HIV-1 infection among male farm workers in Sub-Saharan Africa to control the HIV-1 epidemic.
  
  
  METHODS
  Male farm workers were recruited from a sugar estate in Zambia to participate in a prospective cohort study. Questionnaire data were collected via interview, and testing was conducted for HIV-1, herpes simplex virus type 2 (HSV-2), and syphilis infection at baseline and follow-up between May 2006 and September 2007.
  
  
  RESULTS
  Among 1062 workers enrolled, HIV-1 prevalence at baseline was 20.7%. Testing HSV-2 seropositive (adjusted odds ratio (AOR) 5.4, 95% CI 3.6 to 8.1), self-reported genital ulcers in the past year (AOR 2.8, 95% CI 1.9 to 4.2), and being widowed (AOR 3.7, 95% CI 2.0 to 6.9) were significantly associated with prevalent HIV-1 infection. The HIV-1 incidence among 731 initially negative participants with at least one follow-up visit was 4.1 per 1000 person-months (95% CI 2.6 to 5.7); seroconversion was independently associated with prevalent HSV-2 infection (adjusted hazard ratio (AHR) 2.4, 95% CI 1.0 to 5.8) and incident HSV-2 infection (AHR 18.0, 95% CI 4.2 to 76.3). HIV-1 prevalence and incidence rates were similar among migrant and non-migrant workers.
  
  
  CONCLUSIONS
  HIV-1 prevalence and incidence were high, and HSV-2 infection was a risk factor for HIV-1 acquisition. There is an urgent need to expand HIV-1 prevention programmes tailored to farm workers and their communities.
authors: Centers for Disease Control and Prevention, Global AIDS Program, Lusaka, Zambia. rheffron@uw.edu
authors: Renee
authors: R
authors: Heffron
authors: Ann
authors: A
authors: Chao
authors: Alwyn
authors: A
authors: Mwinga
authors: Sylvester
authors: S
authors: Sinyangwe
authors: Alex
authors: A
authors: Sinyama
authors: Rokaya
authors: R
authors: Ginwalla
authors: J Mark
authors: JM
authors: Shields
authors: Emmanuel
authors: E
authors: Kafwembe
authors: Lovemore
authors: L
authors: Kaetano
authors: Chanda
authors: C
authors: Mulenga
authors: Webster
authors: W
authors: Kasongo
authors: Victor
authors: V
authors: Mukonka
authors: Marc
authors: M
authors: Bulterys
mesh_terms: D000328:Adult; D000368:Aged; D000382:Agricultural Workers' Diseases / Q000453:epidemiology*; D015658:HIV Infections / Q000453:epidemiology*; D015497:HIV-1; D006561:Herpes Simplex / Q000453:epidemiology*; D018258:Herpesvirus 2, Human; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D014171:Transients and Migrants / Q000706:statistics & numerical data*; D055815:Young Adult; D015024:Zambia / Q000453:epidemiology