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

In the current study, investigators examined the role of herpes simplex virus type 2 (HSV-2) and other genital infections on HIV-1 incidence in a cohort study of female hotel/bar workers in Moshi, Tanzania, from 2002 to 2005.

Among 845 HIV-negative participants at the study's start, researchers interviewed and collected blood and genital samples from 689 (81.5 percent) at baseline and at every three months for a total of 698.6 person-years at risk (PYARs). Predictors of HIV-1 incidence were evaluated using a Cox proportional hazards regression model.

The overall HIV-1 incidence was 4.6 per 100 PYARs (95 percent confidence interval [CI], 3.0-6.2/100 PYARs), and use of condoms was very low. Adjusting for other risk factors, HIV infection risk was increased among women with HSV-2 infection at baseline (hazard ratio [HR], 4.3 [95 percent CI, 1.5-12.4]) and in those who acquired HSV-2 during the study (HR, 5.5 [95 percent CI, 1.2-25.4]). In addition, independent predictors of HIV-1 infection were baseline chlamydial infection (HR, 5.2), bacterial vaginosis (HR, 2.1), and occurrence of genital ulcers (HR, 2.7).

"HSV-2 and other genital infections were the most important risk factors for HIV-1," the authors concluded. "Control of these infections could help to reduce HIV-1 incidence in this population."

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