[MOAC103] Infection with trichomonas vaginalis is associated with increased risk for HSV-2 infection among married women in Mysore, India

4th International AIDS Society Conference on HIV Pathogenesis and Treatment

Sydney, Australia - July 22 - 25, 2007

INFECTION WITH TRICHOMONAS VAGINALIS IS ASSOCIATED WITH INCREASED RISK FOR HSV-2 INFECTION AMONG MARRIED WOMEN IN MYSORE, INDIA

IAS Conf HIV Pathog Treat 2007 Jul 22-25;4th: Abstract No. MOAC103

Madhivanan P.¹, Krupp K.², Chandrasekaran V.³, Karat C.³, Arun A.⁴, Klausner J.⁵, Reingold A.⁶
¹University of California, Epidemiology, Albany, United States, ²Asha Kirana Hospital, Mysore, India, ³CSI Holdsworth Memorial hospital, Obstetrics and Gynecology, Mysore, India, ⁴Vikram Hospital, Mysore, India, ⁵University of California, Medicine, San Francisco, United States, ⁶University of California, Epidemiology, Berkeley, United States

OBJECTIVE: During the last several years there is growing evidence that Herpes Simplex virus-2 (HSV-2) infection, in addition to being a significant source of morbidity, is also a risk factor for HIV acquisition and transmission. There are few studies on the correlates and prevalence of HSV-2 infection among married women in Mysore, India. The objective of this study was to investigate risk factors for HSV-2 infection among low-income young married women in Mysore, India.

STUDY DESIGN: A cross-sectional analysis was conducted on baseline data from a longitudinal study among women aged 15-30 years, attending two reproductive health clinics in Mysore, India between October 2005 and 2006. Eligible women were interviewed using a structured interviewer-administered questionnaire, biological specimens were collected for detection of reproductive tract infections (RTI), and treatment was provided for all diagnosed infections.

RESULTS: Out of 898 women, 53.9% had laboratory-diagnosed RTI. Nine percent had trichomoniasis (95% confidence interval [CI]: 8.6%-10.5%), 11% were seropositive for HSV-2 infection (95% CI: 9.4%-13.6%). Bacterial vaginosis was diagnosed in 19% (95% CI: 16.6%-21.8%), and vaginal candidiasis in 30% (95% CI: 27.9%-33.9%). Years of sexual activity (adjusted odds ratio [aOR], 95% CI: 1.47, 1.01-2.13), less education (2.28, 1.42-3.64), having an unskilled laborer as a partner (1.74, 1.06-2.88), and trichomoniasis (3.46, 1.81-6.43) were independent correlates of HSV-2 infection. Being Muslim by religion (0.22, 0.10-0.46) was protective for HSV-2 infection.

CONCLUSIONS: Infection with Trichomonas vaginalis, and Muslim religion were independently associated with prevalent HSV-2 infection. Low cost public health interventions such as aggressive diagnosis and treatment of lower genital tract infections may be a cost effective way to slow the ongoing HIV epidemic among women in India. More research is needed to understand the role of religion and cultural factors like circumcision in Indian men, in prevention of viral infections such as HSV-2 and HIV.

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2007-07-22
MOAC103
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