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The relative prevalence of different STIs in HIV-discordant sexual partnerships: Data from a risk network study in a high-risk New York neighborhood
  1. Samuel Friedman (friedman{at}ndri.org)
  1. National Development and Research Institutes, United States
    1. Melissa Bolyard (melis_b88{at}yahoo.com)
    1. Borough of Manhattan Community College, United States
      1. Milagros Sandoval (sandoval{at}ndri.org)
      1. National Development and Research Institutes, United States
        1. Pedro Mateu-Gelabert (mateu-gelabert{at}ndri.org)
        1. National Development and Research Institutes, United States
          1. Carey Maslow (cmaslow{at}health.nyc.gov)
          1. New York City Department of Health, United States
            1. Jonathan Zenilman (jzenilm1{at}jhmi.edu)
            1. Johns Hopkins Bayview Medical Center, United States

              Abstract

              Objectives: To determine infection patterns of STIs that facilitate HIV transmission among HIV-discordant couples.

              Methods: 112 initial respondents were recruited in an impoverished neighborhood of Brooklyn, NY. Their sexual (and injection) partners were recruited in up to 4 additional network sampling waves for a final sample of 465 persons 18 years or older. After separate informed consent, blood and urine were collected and tested for HIV (EIA/WB); type-specific (FOCUS) anti-HSV-2; syphilis (RPR and TPPA); chlamydia (BDProbeTec Amplified DNA assay) and gonorrhea (BDProbeTec Amplified DNA assay).

              Results: Of 30 HIV-discordant partnerships, 5 were same-sex male partnerships and 25 were opposite-sex partnerships. No subjects tested positive for syphilis or gonorrhea. Two couples were chlamydia-discordant. For HSV-2, 16 couples were double-positive, eight discordant, four double-negative, and two were comprised of a herpes-2-negative with a partner with missing herpes data.

              Conclusions: HSV-2 was present in 83% of the HIV-discordant couples; CT in 7%; and syphilis and gonorrhea in none. HSV-2 is probably more important for HIV transmission than bacterial STDs since it is more widespread. Even given the limited generalizability 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 STD clinics, HIV counseling and testing programs, jails and prisons, needle exchanges, and drug abuse treatment programs. The effects of HSV-suppressive therapy in highly-impacted groups should also be investigated.

              • HIV
              • HSV-2
              • STIs
              • discordant partnerships
              • herpes

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