Objectives: To identify factors associated with herpes simplex virus type 2 (HSV-2) infection among men aged 18–24 in Kisumu, Kenya.
Methods: Baseline data from a randomised trial of male circumcision were analysed. Participants were interviewed for sociodemographic and behavioural risks. The outcome was HSV-2 by antibody status. Risk factors were considered singly and in combination through logistic regression models.
Results: Among 2771 uncircumcised men, 766 (27.6%; 95% confidence interval (CI) 26.0% to 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 four. 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) = 1.22–2.58), being married or having a live-in female partner (AOR = 1.80; 95% CI 1.28 to 2.53), preferring “dry” sex (AOR = 1.39; 95% CI 1.14 to 1.69), reported penile cuts or abrasions during sex (AOR = 1.58; 95% CI 1.32 to 1.91), increasing lifetime sex partners (multiple response categories; AORs ranging from 1.65 to 1.97), and non-student occupation (multiple response categories; AORs ranging from 1.44 to 1.93). Risk decreased with reported condom used at last sex (AOR = 0.82; 95% CI 0.68 to 0.99).
Conclusion: Primary prevention efforts should be initiated at an early age. The same behavioural interventions used currently for HIV prevention—abstinence, reducing the number of sex partners and increasing condom use—should be effective for HSV-2 prevention.
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Funding: This study was funded by grants from the National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda Maryland USA, grant No AI150440, and the Canadian Institutes of Health Research, grant No HCT 44180. Stephen Moses was supported by a CIHR Investigator Award.
Competing interests: None.