Abstract
BackgroundEvidence suggests that a substantial proportion of new HIV infections in African countries are associated with herpes simplex virus type 2 (HSV-2). Thus, the magnitude of HSV-2 infection in an area may suggest the expected course of the HIV epidemic. We determined prevalence of genital herpes, syphilis and associated factors among pregnant women from a remote rural Tanzanian community that has a low but increasing HIV prevalence.MethodsWe analysed 1296 sera and responses to a standard structured questionnaire collected from pregnant women aged between 15–49 years, attending six different antenatal clinics within rural Manyara and Singida regions in Tanzania. Linked anonymous testing (with informed consent) of the serum for specific antibodies against HSV-2 was done using a non-commercial peptide- 55 ELISA. Antibodies against syphilis were screened by using rapid plasma reagin (RPR) and reactive samples confirmed by Treponema pallidum haemagglutination assay (TPHA).ResultsPrevious analysis of the collected sera had shown the prevalence of HIV antibodies to be 2%. In the present study the prevalence of genital herpes and syphilis was 20.7% (95% CI: 18.53–23.00) and 1.6% (95% CI: 1.03–2.51), respectively. The presence of HSV-2 antibodies was associated with polygamy (OR 2.2, 95% CI: 1.62 – 3.01) and the use of contraceptives other than condoms (OR 1.7, 95% CI: 1.21 – 2.41). Syphilis was associated with reporting more than one lifetime sexual partner (OR 5.4, 95% CI: 1.88 – 15.76) and previous spontaneous abortion (OR 4.3, 95% CI: 1.52–12.02).ConclusionThe low prevalence of HIV infection offers a unique opportunity for strengthening HIV prevention in a cost-effective manner. The identification and control of other prevalent curable STIs other than syphilis and specific intervention of HSV-2 in specific populations like pregnant women would be one among approaches towards preventing incident HIV infections.
Highlights
There is strong evidence that a substantial proportion of new HIV infections in African countries are associated with herpes simplex virus type 2 (HSV-2) [1,2,3,4,5,6]
Education provided for participants included HIV- related preventive education and benefits of highly active antiretroviral treatment (HAART) for prevention of mother to child transmission (PMTCT) explained, according to national guidelines for care and treatment of people living with HIV and AIDS
Though we cannot rule out the effect of other STIs on the level HIV infection presented, the identified risk factors for STI are similar to other areas in Tanzania that have experienced a higher level of HIV and related STIs
Summary
Evidence suggests that a substantial proportion of new HIV infections in African countries are associated with herpes simplex virus type 2 (HSV-2). There is strong evidence that a substantial proportion of new HIV infections in African countries are associated with herpes simplex virus type 2 (HSV-2) [1,2,3,4,5,6]. Infection with HSV-2 has a significant impact on the risk of HIV acquisition and the impact increases as the HIV epidemic progresses [7,8]. One reason for this association could be the relative importance of HSV-2 in genital ulcer disease (GUD) in Africa has increased markedly. The magnitude of HSV-2 infection may suggest the expected course of the HIV epidemic
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