Incidence and prevalence of herpes simplex virus type-2 infections among fishermen in Kisumu, Kenya

Abstract

Background: Men with high-risk sexual behavior are important drivers of HIV/STIs in the general population. Prevention of HIV/STIs among suchmen could potentially reduce these infections among women who bear the greatest HIV/STIs disease burden. HSV-2 infection has been shown to be strongly associatedwith HIV infections. We sought to estimate the incidence of HSV-2 infection among fishermen. MethodsM 183 (61%) P<0.01 and 118 (39%) P<0.05, never used condoms with their frequent sexual partners and new sexual partners respectively. Baseline HSV-2 prevalence was 56.3% and married men were 3 times more likely to have HSV-2 infections compared to single (never married) men adjOR 3.2(95% CI; 1.8-5.5), P <0.001. HIV positive men were twice more likely to be co-infected with HSV-2 compared to HIV negativemen adjOR 2.2(95% CI; 1.2-4.2). At baseline, menwho reported only one sexual partner in the last one month were less likely to have HSV-2 infections compared to those who reported multiple sexual partners for the same period adjOR 0.09(95% CI; 0.01-0.74). The annual HSV-2 incidencewas 23.6%. HSV-2 negativemen reporting a casual partner as their most recent sexual partner at baseline had increased risk of HSV-2 acquisition adjRR 6.7(95% CI; 2.4-18.1). Those reporting consistent condom use of over 75% at baseline had reduced risk of acquiring HSV-2 adjRR 0.12(95% CI; 0.03-0.54) P <0.01, whereas those who reported no condom use (0% usage) had increased risk of acquiring HSV-2 adjRR 3.2(95% CI; 1.3-7.9), P <0.01. Multiple number of sexual partners in the past 1 year was strongly associated with incident HSV-2 infection, P <0.01. Conclusion: Fishermen comprise a young sexually-high-risk population, with high HSV-2 incidence and prevalence. Low condom use coupled with concurrent multiple sexual partnerships predispose fishermen to HSV-2 infections.