Correlates of Human Herpesvirus 8 Seropositivity Among Heterosexual Men in Kenya

Few studies have examined heterosexual HHV-8 transmission, which is endemic in African populations. Research has implicated HHV-8 as a causal agent of Kaposi's sarcoma. HHV-8 infection is more common in Africa than in Western populations, and studies have found evidence for both sexual and non-sexual transmission. The current study was a cross-sectional survey of 1,061 men enrolled in a prospective cohort study of risk factors for HIV-1 acquisition among heterosexual trucking company employees in Mombasa, Kenya.

Forty-three percent of participants were HHV-8 seropositive. Seropositivity increased with age, suggesting that some transmission occurs during adulthood in this population, although there is also a prevalence of HHV-8 among adolescents. Men who were uncircumcised and had ever had syphilis were more likely to be seropositive. However, researchers found no significant association between HHV-8 seropositivity and recent sexual behavior, a history of sexual encounters with prostitutes, or HIV-1 status.

The authors found a history of condom use to be associated with decreased likelihood of HHV-8 infection. The researchers also found that Christian religion was positively associated with HHV-8 infection, possibly reflecting differences in sexual behavior or sexual mixing within that population.

The cross-sectional design of the study is a limitation, as it does not account for prepubertal acquisition of HHV-8. Although the current study provides new evidence that HHV-8 transmission occurs during adulthood in African heterosexual populations and may be associated with sexual activity, the researchers stress the need for prospective studies that measure a variety of exposures to establish temporality and causality of risk factors for HHV-8 acquisition among heterosexual populations.

"Our finding that being uncircumcised was independently associated with HHV-8 is novel and suggests possible mechanisms by which HHV-8 may be transmitted. Moreover, our data are the first to suggest that condom use may be protective for HHV-8 infection. Prospective studies are needed to document whether safer sexual practices are able to reduce HHV-8 acquisition," the authors concluded.

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