Abstract
Background. Syphilis is curable but Herpes Simplex Virus-2 (HSV-2) is not. As a result, the prevalence of syphilis but not HSV-2 may be influenced by the efficacy of national STI screening and treatment capacity. If the prevalence of syphilis and HSV-2 is found to be correlated, then this makes it more likely that something other than differential STI treatment is responsible for variations in the prevalence of both HSV-2 and syphilis. Methods. Simple linear regression was used to evaluate the relationship between national antenatal syphilis prevalence and HSV-2 prevalence in women in two time periods: 1990–1999 and 2008. Adjustments were performed for the laboratory syphilis testing algorithm used and the prevalence of circumcision. Results. The prevalence of syphilis was positively correlated with that of HSV-2 for both time periods (adjusted correlations, 20–24-year-olds: 1990–99: R 2 = 0.54, P < 0.001; 2008: R 2 = 0.41, P < 0.001 and 40–44-year-olds: 1990–99: R 2 = 0.42, P < 0.001; 2008: R 2 = 0.49, P < 0.001). Conclusion. The prevalence of syphilis and HSV-2 is positively correlated. This could be due to a common set of risk factors underpinning both STIs.
Highlights
Is there a correlation between the national prevalence of syphilis and Herpes Simplex Virus-2 (HSV-2)? The answer to this question may provide useful information on the determinants of differences in STI prevalence
It has long been argued that STI screening and treatment efficacy (STISTE) was instrumental in the large reductions in syphilis prevalence seen in the mid-20th century in many countries [1]
We found a positive association between syphilis prevalence and 20–24-year-olds HSV-2 prevalence (1990–99: R2 = 0.59, P < 0.001, n = 32; 2008: R2 = 0.41, P < 0.001, n = 31; Figure 2) and 40–44-year-olds HSV2 prevalence (1990–99: R2 = 0.41, P < 0.001, n = 26; 2008: R2 = 0.49, P < 0.001, n = 36)
Summary
Is there a correlation between the national prevalence of syphilis and Herpes Simplex Virus-2 (HSV-2)? The answer to this question may provide useful information on the determinants of differences in STI prevalence. The prevalence of HSV-2 can be thought of as a measure of the prevalence of non-STI-STE related risk factors in a population [6]. It is more useful in this regard than HIV as, unlike HIV, HSV-2’s transmission/acquisition has not been shown to be enhanced by the presence of other STIs such as syphilis [7, 8]. If we find a correlation this makes it more probable that shared risk factors are responsible and that STI-STE is less likely to be a major player in this regard. This could be due to a common set of risk factors underpinning both STIs
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