@article {Maughan-Brown443, author = {Brendan Maughan-Brown and Gavin George and Sean Beckett and Meredith Evans and Lara Lewis and Cherie Cawood and David Khanyile and Ayesha B M Kharsany}, title = {Age-disparate partnerships and HSV-2 among adolescent girls and young women in South Africa: implications for HIV infection risk}, volume = {95}, number = {6}, pages = {443--448}, year = {2019}, doi = {10.1136/sextrans-2018-053577}, publisher = {The Medical Society for the Study of Venereal Disease}, abstract = {Objective There is an urgent need to understand high HIV-infection rates among young women in sub-Saharan Africa. While age-disparate partnerships have been characterised with high-risk sexual behaviours, the mechanisms through which these partnerships may increase HIV-risk are not fully understood. This study assessed the association between age-disparate partnerships and herpes simplex virus type-2 (HSV-2) infection, a factor known to increase HIV-infection risk.Methods Cross-sectional face-to-face questionnaire data, and laboratory HSV-2 and HIV antibody data were collected among a representative sample in the 2014/2015 household survey of the HIV Incidence Provincial Surveillance System in KwaZulu-Natal, South Africa. Among 15{\textendash}24-year-old women who reported having ever had sex (n=1550), the association between age-disparate partnerships (ie, male partner >=5 years older) and HSV-2 antibody status was assessed using multivariable Poisson regression models with robust variance. Analyses were repeated among HIV-negative women.Results HSV-2 prevalence was 55\% among 15{\textendash}24-year-old women. Women who reported an age-disparate partnership with their most recent partner were more likely to test HSV-2 positive compared with women with age-similar partners (64\% vs 51\%; adjusted prevalence ratio (aPR):1.19 (95\% CI 1.07 to 1.32, p\<0.01)). HSV-2 prevalence was also significantly higher among HIV-negative women who reported age-disparate partnerships (51\% vs 40 \%; aPR:1.25 (95\% CI 1.05 to 1.50, p=0.014)).Conclusions Results indicate that age-disparate partnerships are associated with a greater risk of HSV-2 among young women. These findings point towards an additional mechanism through which age-disparate partnerships could increase HIV-infection risk. Importantly, by increasing the HSV-2 risk, age-disparate partnerships have the potential to increase the HIV-infection risk within subsequent partnerships, regardless of the partner age-difference in those relationships.}, issn = {1368-4973}, URL = {https://sti.bmj.com/content/95/6/443}, eprint = {https://sti.bmj.com/content/95/6/443.full.pdf}, journal = {Sexually Transmitted Infections} }