Abstract

ARV Adherence vs. Cultural Compliance: HIV/AIDS Drug Therapy and Decision-Making among PLWHA in Rural Botswana

Highlights

  • Herpes simplex type 2 (HSV-2) infection is associated with increased HIV-1 infectiousness and transmission [1]

  • Compared to intervals when there were no symptoms or sores, swabs collected when women had symptoms in the three-day window prior were 2.0 times as likely to be positive for herpes simplex virus type 2 (HSV-2) DNA; this association was stronger when women had sores alone, at 2.7 and when they had sores and symptoms (PR: 2.8, 95% confidence interval (CI): 1.7-4.5)

  • It found that genital ulcer disease (GUD) and HSV-2 genital shedding were associated with higher plasma HIV viral load

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Summary

Introduction

Herpes simplex type 2 (HSV-2) infection is associated with increased HIV-1 infectiousness and transmission [1]. HSV-2 might increase the risk of HIV transmission due to genital vesicles and ulcers, and shedding of HIV through these breaches in epithelial integrity [2]. Increased risk of HIV-1 transmission might be the result of increased HIV replication and shedding mediated by cytokine production and co-infection of HIV-infected cells [3,4,5]. Studies demonstrating increased HIV-1 transmission in the presence of HSV-2 infection have been primarily conducted in persons with genital ulcers who comprise a small proportion of all persons with HSV-2 infection. There are few studies examining HIV shedding during asymptomatic HSV-2 infection or in the presence of genital symptoms other than

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