title: The epidemiology of HIV and HSV-2 infections among women participating in microbicide and vaccine feasibility studies in Northern Tanzania.
abstract: OBJECTIVE
  To prepare for future HIV prevention trials, we conducted prospective cohort studies among women working in food and recreational facilities in northern Tanzania. We examined the prevalence and incidence of HIV and HSV-2, and associated risk factors.
  
  
  METHODS
  Women aged 18-44 years working in food and recreational facilities were screened to determine their eligibility for the studies. Between 2008-2010, HIV-negative women were enrolled and followed for 12 months. At enrolment and 3-monthly, we collected socio-demographic and behavioural data, and performed clinical examinations for collection of biological specimens that were tested for reproductive tract infections. Risk factors for HIV and HSV-2 incidence were investigated using Poisson regression models.
  
  
  RESULTS
  We screened 2,229 and enrolled 1,378 women. The median age was 27 years (interquartile range, IQR 22, 33), and median duration working at current facility was 2 years. The prevalences of HIV at screening and HSV-2 at enrolment were 16% and 67%, respectively. Attendance at the 12-month visit was 86%. HIV and HSV-2 incidence rates were 3.7 (95% confidence interval, CI: 2.8,5.1) and 28.6 (95% CI: 23.5,35.0)/100 person-years, respectively. Women who were separated, divorced, or widowed were at increased risk of HIV (adjusted incidence rate ratio, aRR = 6.63; 95% CI: 1.97,22.2) and HSV-2 (aRR = 2.00; 95% CI: 1.15,3.47) compared with married women. Women reporting ≥3 partners in the past 3 months were at higher HIV risk compared with women with 0-1 partner (aRR = 4.75; 95% CI: 2.10,10.8), while those who had reached secondary education or above were at lower risk of HSV-2 compared with women with incomplete primary education (aRR = 0.42; 95% CI: 0.22,0.82).
  
  
  CONCLUSIONS
  HIV and HSV-2 rates remain substantially higher in this cohort than in the general population, indicating urgent need for effective interventions. These studies demonstrate the feasibility of conducting trials to test new interventions in this highly-mobile population.
authors.affiliation: London School of Hygiene and Tropical Medicine, London, United Kingdom. Saidi.Kapiga@lshtm.ac.uk
authors.forename: Saidi H
authors.initials: SH
authors.lastname: Kapiga
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Ewings
authors.forename: Tony
authors.initials: T
authors.lastname: Ao
authors.forename: Joseph
authors.initials: J
authors.lastname: Chilongani
authors.forename: Aika
authors.initials: A
authors.lastname: Mongi
authors.forename: Kathy
authors.initials: K
authors.lastname: Baisley
authors.forename: Suzanna
authors.initials: S
authors.lastname: Francis
authors.forename: Aura
authors.initials: A
authors.lastname: Andreasen
authors.forename: Ramadhan
authors.initials: R
authors.lastname: Hashim
authors.forename: Deborah
authors.initials: D
authors.lastname: Watson-Jones
authors.forename: John
authors.initials: J
authors.lastname: Changalucha
authors.forename: Richard
authors.initials: R
authors.lastname: Hayes
mesh_terms: D016915:AIDS Vaccines; D000328:Adult; D000367:Age Factors; D000890:Anti-Infective Agents; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D019649:Food Industry; D015658:HIV Infections / Q000453:epidemiology*; D006558:Herpes Genitalis / Q000453:epidemiology*; D018258:Herpesvirus 2, Human; D006801:Humans; D015994:Incidence; D017533:Marital Status; D008403:Mass Screening; D015995:Prevalence; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D013636:Tanzania / Q000453:epidemiology
chemical_list: D016915:AIDS Vaccines; D000890:Anti-Infective Agents