Objectives: This analysis sought to identify factors associated with herpes simplex virus type 2 (HSV-2) infection among men aged 18-24 in Kisumu, Kenya.
Methods: We analyzed baseline data from a randomized trial of male circumcision. Participants were interviewed for socio-demographic and behavioral risks. The outcome was HSV-2 by antibody status. Risk factors were considered singly and in combination through logistic regression models.
Results: Among 2,771 uncircumcised men, 766 (27.6%; 95% confidence interval [CI]: 26.0-29.3%) tested antibody positive for HSV-2. The median age at first sex was 16 years, and the median number of lifetime sexual partners was 4. HSV-2 seroprevalence increased from 19% among 18 year-olds to 43% among 24 year-olds (p<0.001). In multivariable analysis, statistically significant risks for infection were: increasing age (adjusted odds ratio [AOR] ranged from 1.22-2.58), being married or having a live-in female partner (AOR=1.80; 95% CI: 1.28-2.53), preferring "dry" sex (AOR=1.39; 95% CI: 1.14-1.69), reported penile cuts or abrasions during sex (AOR=1.58; 95% CI: 1.32 – 1.91), increasing lifetime sex partners (multiple response categories; AORs ranging 1.65-1.97), and non-student occupation (multiple response categories; AORs ranging 1.44-1.93). Risk decreased with reported condom used at last sex (AOR=0.82; 95% CI: 0.68-0.99).
Conclusion: Primary prevention efforts should be initiated at an early age. The same behavioral interventions used currently for HIV prevention- abstinence, reducing number of sex partners, and increasing condom use- should be effective for HSV-2 prevention.
- behavioral risk
- genital herpes