Abstract:
OBJECTIVES:Herpes simplex virus-2 (HSV-2) and syphilis are associated with increased risk of HIV, highlighting the importance of understanding their transmission dynamics. In India, most studies of HSV-2 and syphilis incidence are in high-risk populations and may not accurately reflect infectious activity. In this study, we aim to define HSV-2/syphilis incidence and risk factors in a population sample. METHODS:We conducted a longitudinal population-based survey in Andhra Pradesh, India, in two rounds: 2004-2005 and 2010-2011. Sociodemographic and behavioural data were collected, and dried blood spots tested for HSV-2 and Treponema pallidum IgG. After calculating sexually transmitted infection (STI) incidence, associated factors were assessed using modified Poisson regression and within-couple transmission rates modelled using seroconcordance/discordance data. RESULTS:12,617 adults participated at baseline with 8494 at follow-up. Incidence of HSV-2 and syphilis per 1000 person-years was 25.6 (95% CI 24.1 to 27.2) and 3.00 (95% CI 2.52 to 3.54). Incidence of HSV-2 was higher in women vs. men (31.1 vs. 20.2) and in rural vs urban residents (31.1 vs 19.0) (p<0.05 for both). STI seroincidence increased in a step-wise fashion with age and was associated with spousal seropositivity for both sexes (incidence rate ratio (IRR) 2.59 to 6.78). Within couples the rate of transmission per 1000 couple-years from men to women vs. women to men was higher for HSV-2 (193.3 vs. 119.0) compared with syphilis (27.6 vs. 198.8), p<0.05 for both. CONCLUSIONS:HSV-2 has higher incidence among subpopulations such as women, rural residents and older-aged individuals, suggesting a need for more generalised STI prevention approaches among populations traditionally considered low risk.
journal_name
Sex Transm Infectjournal_title
Sexually transmitted infectionsauthors
Hochberg CH,Schneider JA,Dandona R,Lakshmi V,Kumar GA,Sudha T,Akbar M,Ahmed GM,Ramgopal SP,Armbruster B,Alary M,Dandona Ldoi
10.1136/sextrans-2014-051708subject
Has Abstractpub_date
2015-08-01 00:00:00pages
375-82issue
5eissn
1368-4973issn
1472-3263pii
sextrans-2014-051708journal_volume
91pub_type
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