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Journal Article

The Role of Herpes Simplex Virus Type 2 and Other Genital Infections in the Acquisition of HIV-1 among High-Risk Women in Northern Tanzania

Saidi H. Kapiga, Noel E. Sam, Heejung Bang, Quanhong Ni, Trong T. H. Ao, Ireen Kiwelu, Sarah Chiduo, Uzodinma Ndibe, George Seage III, Paul Coplan, John Shao, Zeda F. Rosenberg and Max Essex
The Journal of Infectious Diseases
Vol. 195, No. 9 (May 1, 2007), pp. 1260-1269
Published by: Oxford University Press
Stable URL: http://www.jstor.org/stable/30087031
Page Count: 10
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The Role of Herpes Simplex Virus Type 2 and Other Genital Infections in the Acquisition of HIV-1 among High-Risk Women in Northern Tanzania
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Abstract

Background. We examined the role of herpes simplex virus type 2 (HSV-2) and other genital infections on human immunodeficiency virus type 1 (HIV-1) incidence in a cohort study conducted between 2002 and 2005 among female bar/hotel workers in Moshi, Tanzania. Methods. At baseline and every 3 months thereafter, participants were interviewed, and blood and genital samples were collected. Predictors of HIV-1 incidence were evaluated using a Cox proportional hazards regression model. Results. Of 845 women who were HIV-1 seronegative at baseline, 689 (81.5%) were monitored in the study for a total of 698.6 person-years at risk (PYARs). The overall HIV-1 incidence was 4.6/100 PYARs (95% confidence interval [CI], 3.0-6.2/100 PYARs), and condom use was very low. After adjustment for other risk factors, the risk of HIV-1 was increased among women with HSV-2 at baseline (hazard ratio [HR], 4.3 [95% CI, 1.5-12.4]) and in those who acquired HSV-2 during the study period (HR, 5.5 [95% CI, 1.2-25.4]). Other independent predictors of HIV-1 were baseline chlamydial infection (HR, 5.2), bacterial vaginosis (HR, 2.1), and the occurrence of genital ulcers (HR, 2.7). Conclusion. HSV-2 and other genital infections were the most important risk factors for HIV-1. Control of these infections could help to reduce HIV-1 incidence in this population.

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