Background: Herpes Simplex Virus Type 2 (HSV 2) is one of the most common sexually transmitted infections (STIs) worldwide. HSV 2 infection is a risk factor for the acquisition and transmission of other STIs.
Aim: The aim of this study is to determine prevalence and predictors of HSV 2 infection in Durban, South Africa by using available data that has not been previously analysed for the purpose of adding scientific evidence to the existing body of knowledge relating to HSV 2.
Method: The study involves secondary analyses of data collected as a prospective study which enrolled women who participated in a clinical trial. A total of 3472 sexually active women were screened in the primary study from two clinics in Durban. All consenting participants were tested for HIV, HSV 2, Trichomonas vaginalis (TV), Neisseria gonorrhoea (NG) and Chlamydia trachomatis (CT) infection.
Results: There were 2532 women who had HSV 2 giving a prevalence of 73%. Of these, 53% also tested positive for HIV infection. In univariate analysis, co-infection with HIV was strongly associated with HSV2 (Odds Ratio (OR): 7.4, 95% Confidence Interval (CI): 6.0, 9.1, p<0.001). There was also an association between other STIs, such as CT, NG and syphilis and HSV 2, although only NG was significantly associated with prevalent of HSV 2 (OR: 2.3, 95% CI: 1.3, 4.1, p=0.005). Women older than 25 years of age more likely to have HSV 2 (OR: 2.4, 95% CI: 2.0,2.8, p<0.001). A risk of being infected with HSV 2 increased with the number of reported lifetime sexual partners Those with two and three or more were 2,5 and 4.6 times more likely to have HSV2 respectively (OR: 2.5, 95% CI: 2.1,3.1, p<0.001 and OR: 4.6, 95% CI: 3.8, 5.6, p<0.001 respectively). Women who had less than high school education were also found to have higher risk for HSV 2.
Conclusion: The secondary analysis showed a high prevalence of HSV 2 infection and a strong association of HSV 2 and HIV. A significant association of HSV 2 was noted in women having more than two sex partners and lower high school education. Therefore, it is recommended that screening for HSV 2 among high risk populations be incorporated into the STI screening and treatment packages.
Prevalence and risk factors associated with HSV 2
Herpes Simplex Virus Type 2
HSV 2
