PT  - JOURNAL ARTICLE
AU  - S P Kouyoumjian
AU  - G R Mumtaz
AU  - P Vickerman
AU  - L J Abu-Raddad
TI  - P3.235 Global Ecological Study of HIV and HSV-2 Prevalence
AID  - 10.1136/sextrans-2013-051184.0692
DP  - 2013 Jul 01
TA  - Sexually Transmitted Infections
PG  - A222--A222
VI  - 89
IP  - Suppl 1
4099  - http://sti.bmj.com/content/89/Suppl_1/A222.2.short
4100  - http://sti.bmj.com/content/89/Suppl_1/A222.2.full
SO  - Sex Transm Infect2013 Jul 01; 89
AB  - Background HIV and herpes simplex virus type-2 (HSV-2) are infections transmitted predominantly through sexual intercourse. We explored the ecological association between the prevalence of HIV and HSV-2 among human populations through a global review. Methods We conducted a global systematic literature review of HIV and HSV-2 prevalence following the PRISMA guidelines. Sources of data used were Medline (PubMed) and Embase databases, and several country-level reports. No language, country, or year limitations were imposed. We included any publication with a serological measurement of HIV and HSV-2 prevalence in the same study population. Results A total of 2,927 records were screened. Based on preliminary descriptive analysis, we found that HIV prevalence increased steadily with HSV-2 prevalence in all populations where the dominant mode of transmission was sexual. HSV-2 prevalence was consistently larger than HIV prevalence. Overall, among high-risk populations, both infections prevalence was high. Among general population groups, HIV prevalence varied across settings, but was correlated with HSV-2 prevalence, which also varied widely. Though HIV and HSV-2 prevalence levels were correlated across populations, there were settings with very low HIV prevalence regardless of HSV-2 prevalence. For children and injecting drug users where the dominant mode of HIV transmission was not sexual, there was no apparent ecological association between the two infections. Conclusions Our findings support a strong ecological association between HIV and HSV-2 prevalence in all populations where the dominant mode of HIV transmission is sexual. Sexual networks conducive of HSV-2 transmission appear to be also conducive of HIV transmission. Further analytical work is needed to quantify the ecological association between the two infections, to determine whether HSV-2 could be predictive of HIV epidemic potential, and to assess whether there is a threshold of HSV-2 prevalence necessary for a sexual network to be sustainable for HIV transmission besides HSV-2 transmission.