Herpes simplex virus type 2 among mobile pastoralists in northwestern Namibia.
BACKGROUND
Although herpes simplex virus type 2 (HSV-2) epidemiology has been described for many western and/or urban populations, disease burden has not been characterized for remote, non-western, under treated populations, where patterns of risk and vulnerability may be very different.


OBJECTIVE
To understand demographic, behavioural and geographic influences on risk for HSV-2 in a population of mobile, rural pastoralists in northwestern Namibia.


METHODS
The authors conducted a cross-sectional survey of reproductively aged adults (n = 445) across 28 villages in Kaokoveld, Namibia. All participants completed a questionnaire of demographic data, ecological interactions and sexual behaviour, and a rapid test specific for HSV-2.


RESULTS
HSV-2 status was significantly associated with being female (OR = 3.1, 95% CI = 2.00, 4.71), increasing age (men: OR = 7.5, 95% CI = 2.67, 20.85; women: OR = 6.2, 95% CI = 2.48, 15.50) and with higher wealth among men (OR = 5.1, 95% CI = 1.98, 13.09).


CONCLUSIONS
Higher risk among women can be explained, in part, by local hygiene practices and a preference for "dry" sex. There was considerable variation in prevalence by region, which appears to be linked to geographic remoteness. Culturally contextualized epidemiologic studies of remote, vulnerable populations can provide essential information for limiting the introduction and spread of new infections.
a School of Natural Resources and Environment, University of Michigan , Ann Arbor , MI , USA .|b Department of Anthropology , Stanford University , Stanford , CA , USA , and.
Ashley
A
Hazel
c School of Public Health, Department of Epidemiology, University of Michigan , Ann Arbor , MI , USA.
Betsy
B
Foxman
a School of Natural Resources and Environment, University of Michigan , Ann Arbor , MI , USA .
Bobbi S
BS
Low
D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006558:Herpes Genitalis / Q000453:epidemiology* / Q000821:virology; D018258:Herpesvirus 2, Human / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009276:Namibia / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population; D055815:Young Adult
HSV-2; Southern Africa; nomads; rural health; sexually transmitted disease