AEGiS-13IAC: HIV1 / HSV-2 co-infection and sero-concordance among heterosexual couples in Harare, Zimbabwe.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

HIV1 / HSV-2 co-infection and sero-concordance among heterosexual couples in Harare, Zimbabwe.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. ThOrC726)

Gwanzura L, Machekano R, Bassett M, Latif A, Mason P, Katzenstein D;;; L. Gwanzura, Dept. of Medical Laboratory Technology, UZ, Box A178, Avondale, Harare, Zimbabwe, Tel.: +263 4 79 16 31, E-mail: dmlt@healthnet.zw

BACKGROUND: HSV-2 is likely the most common cause of genital ulceration in Zimbabwe and may contribute to increased transmission of HIV. We examined HIV1 and HSV2 co-infection patterns within married couples and associated risk factors.

METHODS: HIV and HSV2 serostatus of female partners of men participating in an HIV intervention trial were matched to their partner's results. Multivariate models determined risk factors for co-infection.

RESULTS: Female and male HIV prevalence was 23% and 20%, respectively. HSV2 prevalence was 56% among women and 42% men. Of the 317 women who had both HIV and HSV2 serologies, 19.2% were co-infected with both, 4.1% were HIV+/HSV2- negative and 36.9% were HSV2+/HIV-. Among men, 14.6% were HIV+/ HSV2+, 5.4 % were HIV+/HSV2-,and 27.6% were HSV2+/HIV-. Risk factors associated with HIV positive concordance among couples were husband's HSV2 seropositivity (OR 4.8), husband's report of multiple partners (OR 4.2) and alcohol consumption (OR 2.4), and vaginal discharge (OR 11.0) and genital ulcer (OR 3.8) by the wife. HSV2 positive concordance was entirely determined by factors related to the husband's behavior and the duration of the sexual partnerships. Partnerships with married (OR4.2), older (OR 1.08 per year), HIV positive (OR 4.4), and beer drinking (OR 1.9) men were more likely to be concordant for HSV2.

CONCLUSION: Results suggest that women are at a higher risk of acquiring HIV andSV2 infections, but that behavior among their male partners drive transmission. Prevention efforts to reduce HIV transmission in couples should focus on male behavior including drinking and multiple sexual partners. HSV2 infection appears to enhance heterosexual HIV transmission.

Keywords: AEGIS, Heterosexuality, Herpesvirus 2, Human, HIV Infections, Sexual Partners, Risk Factors, HIV Seropositivity, Prevalence, Sexuality, Zimbabwe, Case-Control Studies, Greece, Human, Male, Female
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