Abstract | BACKGROUND: Risk factors influencing the incidence of human immunodeficiency virus ( HIV) infection were investigated in a case-control study nested within a community-randomized trial of treatment of syndromic sexually transmitted infections ( STIs) in rural Tanzania. METHODS: Case patients were persons who became HIV positive, and control subjects were randomly selected from among persons who remained HIV negative. For each sex, we obtained adjusted odds ratios ( ORs) and population-attributable fractions (PAFs) for biomedical and behavioral factors. RESULTS: We analyzed 92 case patients and 903 control subjects. In both sexes, the incidence of HIV infection was significantly higher in subjects with an HIV-positive spouse than in those with HIV-negative spouse (men: OR, 25.1; women: OR, 34.0). The incidence of HIV infection was significantly higher in those who became positive for herpes simplex virus type 2 (HSV-2) (men: OR, 5.60; women: OR, 4.76) and those who were HSV-2-positive at baseline (men: OR, 3.66; women: OR, 2.88) than in subjects who were HSV-2 negative. In women, living elsewhere (OR, 3.22) and never having given birth (OR, 4.27) were significant risk factors. After adjustment, the incidence of HIV infection was not significantly associated with a history of injections or STIs in either sex. CONCLUSION: HSV-2 infection was the most important risk factor for HIV infection, which highlights the need for HSV-2 interventions in HIV infection control, and there were particularly strong associations with recent HSV-2 seroconversion. The PAF associated with having an HIV-positive spouse was low, but this is likely to increase during the epidemic.
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Authors | James Todd, Heiner Grosskurth, John Changalucha, Angela Obasi, Frank Mosha, Rebecca Balira, Kate Orroth, Stephane Hugonnet, Mar Pujades, David Ross, Awene Gavyole, David Mabey, Richard Hayes |
Journal | The Journal of infectious diseases
(J Infect Dis)
Vol. 193
Issue 3
Pg. 458-66
(Feb 01 2006)
ISSN: 0022-1899 [Print] United States |
PMID | 16388496
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Topics |
- Adolescent
- Adult
- Case-Control Studies
- Disease Outbreaks
- Female
- HIV Infections
(complications, epidemiology)
- Herpes Genitalis
(complications)
- Herpesvirus 2, Human
- Humans
- Incidence
- Male
- Middle Aged
- Risk Factors
- Rural Population
- Sexual Behavior
- Sexual Partners
- Tanzania
(epidemiology)
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