Article Text


Epidemiology poster session 5: Transmission dynamic
P1-S5.04 HSV-2 Prevalence and Incidence among Stable HIV-1 Discordant Couples in Nairobi, Kenya
  1. A Muiru,
  2. R Bosire,
  3. B Guthrie,
  4. R Choi,
  5. M Merkel,
  6. B Chohan,
  7. J Kiarie,
  8. B Lohman-Payne,
  9. C Farquhar
  1. Kenya Research Group, International AIDS Research and Training Program, Seattle, USA


Background To describe HSV-2 prevalence, incidence and their correlates among stable HIV-1 discordant heterosexual couples enrolled in an HIV-1 prevention cohort study in Nairobi, Kenya.

Methods Between 2007 and 2009, 469 HIV-1 discordant couples were recruited from VCT centers, and were followed up quarterly for up to 2 years. Clinical staff administered a questionnaire assessing socio-demographics, behaviour, and biological characteristics. HSV-2 status was assessed using Focus Herpe-Select2 HSV IgG ELISA. Correlates of HSV-2 infection at enrolment, and during follow-up were identified by logistic regression and Cox proportional hazards analysis respectively.

Results Of the couples, 189 (40%) were HSV-2 concordant positive, 114 (24%) were HSV-2 discordant, and 85 (18%) were concordant negative. The incidence of HSV-2 infection was 8.7 cases/100 person-years. 19 (17%) individuals in an initially HSV-2 discordant partnership and 11 (13%) in an initially HSV-2 concordant negative partnership acquired HSV-2 during follow-up. Of these 11 individuals, 9(81%) were the HIV-1 positive index case in the HIV-1 discordant relationship. In a multivariate analysis, HSV-2 prevalence at baseline was significantly associated with female gender (OR 4.4; (95% CI 2.9 to 6.7)), having an HSV-2 positive partner (OR 7.6; (95% CI 5.1 to 11.2)), being HIV positive (OR 2.2; (95% CI 1.5 to 3.1)), increasing age (OR 1.08; (95% CI 1.05 to 1.1)), and older age at sexual debut was protective (OR 0.87; (95% CI 0.83 to 0.93)). HSV-2 incidence during follow-up was significantly associated with female gender (HR 3.5; (95% CI 1.6 to 8.0)), having an HSV-2 positive partner (HR 4.9; (95% CI, 2.0 to 9.9)), and history of any other STI (HR 2.6; (95% CI 1.3 to 5.8)).

Conclusions This is the first large study to report the prevalence and incidence of HSV-2 among sexual partners who are in a stable HIV-1 discordant relationship. Female gender, a history of any other STI, and having an HSV-2 positive partner were associated with an increased risk of acquiring HSV-2. 11 individuals a majority of them with HIV acquired HSV-2 during follow-up despite being in HSV-2 concordant negative relationship at enrolment. The high incidence of HSV-2 in couples who were initially HSV-2 concordant negative or HSV-2 discordant highlights the dire need for continuing comprehensive STD prevention programs particularly among high risk population Sub-Saharan Africa.

Statistics from

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.