title: Prevalence of Herpes Simplex Virus 2 (HSV-2) infection and associated risk factors in a cohort of HIV negative women in Durban, South Africa.
abstract: BACKGROUND
  Herpes Simplex Virus 2 (HSV-2) is one of the most common sexually transmitted infections (STIs) worldwide and is a risk factor for the acquisition and transmission of other STIs, including HIV. We determined the prevalence and predictors of HSV-2 infection among women screened for a HIV prevention trial in Durban, South Africa. Univariate and multivariate logistic and Cox regression models were used to determine the correlates and predictors of HSV-2 infection at enrolment and seroconversion during the study respectively.
  
  
  RESULTS
  Prevalence of HSV-2 at screening was 65% and crude incidence was 22.3 per 100 person-years (PY) (95% CI 20.4-24.3). The HIV seroconversion was significantly higher among those testing positive for HSV-2 at baseline compared to women who were negative [8.7 per 100 person years (PY) versus 5.2 per 100 PY; (p < 0.001)]. In univariate analysis, age was determined to be the most significant predictor for HSV-2 diagnosis, while co-infection with syphilis was also a significant predictor, while age and co-infection with syphilis remained the two most significant predictors of having HSV-2 in multivariate analysis at baseline. Consistent with these results, along with HIV seroconversion, age was also identified as a significant predictor for incidence of HSV-2.
  
  
  CONCLUSIONS
  Given the unacceptably high prevalence and incidence rates of HSV-2 infection reported here, HSV-2 and general STI education needs to be reinforced in these communities, with a focus on condom education for prevention. HSV-2 has emerged as the most prevalent STI which is most often asymptomatic and unrecognized, and which increases women's risk of acquiring other STIs, including HIV.
authors.affiliation: HIV Prevention Research Unit, Medical Research Council, Durban, South Africa. Brodie.Daniels@mrc.ac.za.
authors.forename: Brodie
authors.initials: B
authors.lastname: Daniels
authors.affiliation: The Kirby Institute, Sydney, Australia.
authors.forename: Handan
authors.initials: H
authors.lastname: Wand
authors.affiliation: HIV Prevention Research Unit, Medical Research Council, Durban, South Africa.
authors.forename: Gita
authors.initials: G
authors.lastname: Ramjee
mesh_terms: D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D004311:Double-Blind Method; D005260:Female; D018023:HIV Seronegativity; D006558:Herpes Genitalis / Q000453:epidemiology* / Q000378:metabolism; D018258:Herpesvirus 2, Human; D006801:Humans; D015994:Incidence; D015995:Prevalence; D016016:Proportional Hazards Models; D012307:Risk Factors; D000069078:Seroconversion; D013019:South Africa; D055815:Young Adult
keywords: HSV-2; Risk factors; South Africa; Women