Relative prevalence of different sexually transmitted infections in HIV-discordant sexual partnerships: data from a risk network study in a high-risk New York neighbourhood
- 1National Development and Research Institutes, Inc, New York, NY, USA
- 2Borough of Manhattan Community College, New York, NY USA
- 3New York City Department of Health, New York, NY, USA
- 4Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
- Dr S R Friedman, National Development and Research Institutes, Inc, 71 W 23rd Street, 8th floor, New York, NY 10010, USA;
- Accepted 22 August 2007
- Published Online First 29 August 2007
Objectives: To determine infection patterns of sexually transmitted infections that facilitate HIV transmission among HIV-discordant couples.
Methods: 112 initial respondents were recruited in an impoverished neighbourhood of Brooklyn, New York. Their sexual (and injection) partners were recruited in up to four additional network sampling waves for a final sample of 465 persons aged 18 years or older. After separate informed consent had been obtained, blood and urine were collected and tested for HIV, type-specific antibodies to herpes simplex virus (HSV-2), syphilis, chlamydia and gonorrhoea.
Results: Of 30 HIV-discordant partnerships, five were same-sex male partnerships and 25 were opposite-sex partnerships. No subjects tested positive for syphilis or gonorrhoea. Two couples were chlamydia-discordant. For HSV-2, 16 couples were double-positive, eight discordant, four double-negative, and two comprised a HSV-2-negative with a partner with missing herpes data.
Conclusions: HSV-2 was present in 83% of the HIV-discordant couples, chlamydia in 7%, and syphilis and gonorrhoea in none. HSV-2 is probably more important for HIV transmission than bacterial sexually transmitted diseases because it is more widespread. Even given the limited generalisability of this community-based sample, there seems to be an important HIV-prevention role for herpes detection and prevention activities in places where HIV-infected people are likely to be encountered, including sexually transmitted disease clinics, HIV counselling and testing programmes, prisons, needle exchanges, and drug abuse treatment programmes. The effects of HSV-suppressive therapy in highly impacted groups should also be investigated.
Funding: Funding was provided by US National Institute on Drug Abuse (NIDA) project R01 DA13128 (Networks, Norms, and HIV/STI Risk among Youth). NIDA had no role beyond that in the creation of this paper.
Competing interests: None.