Herpes Simplex Virus Type-2 and Human Immunodeficiency Virus infections in a rural population in Kilimanjaro Tanzania
Objectives: To estimate the seroprevalence of Herpes Simplex Type 2 (HSV-2) and its association with Human Immunodeficiency Virus type 1 (HIV-1) infections in rural Kilimanjaro Tanzania.
Methods: A cross-sectional survey was conducted in Oria village from March to June 2005 involving all individuals aged 15-44 years with permanent address in the village. Following an informed written consent, participants gave blood for HIV-1 testing and further interviewed regarding their risk behaviours. All HIV cases and randomly selected controls were tested for HSV-2 antibodies.
Results: The weighted HSV-2 seroprevalence estimate in the whole population was 33.2%. The HSV-2 seroprevalence was 87.5% and 29.5% among HIV-1 seropositive cases and seronegative controls respectively (Odds ratio (OR) 2.9; 95% Confidence interval: 1.9-4.3). After adjusting for sexual risk behaviors, the association between HSV-2 and HIV-1 infections remained strong (adjusted OR 14.1; CI: 5.0-28.3). Multiple sexual partners, transactional sex and unprotected casual sex were independently associated with HIV-1 infection.
Conclusions: These results demonstrate that HSV-2 is highly prevalent in rural communities in Tanzania and strongly associated with HIV-1 infection. Sexual risk behaviours may play a major role in the transmission of both HSV-2 and HIV-1 infection. Due to lack of HSV-2 suppressive antiretroviral therapy in this and similar communities, prevention through promotion of behavioural change might be the most important strategy to mitigate HSV-2 and HIV-1 transmission.
Keywords: HSV-2, HIV-1, sexual risk behaviors, rural Tanzania