Sexually transmitted bedfellows: exquisite association between HIV and HSV2 in 21 communities in Southern Africa in the HPTN 071 (PopART) study

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Title: Sexually transmitted bedfellows: exquisite association between HIV and HSV2 in 21 communities in Southern Africa in the HPTN 071 (PopART) study
Authors: Bradley, J
Floyd, S
Piwowar-Manning, E
Laeyendecker, O
Young, A
Bell-Mandla, N
Bwalya, J
Bock, P
Fidler, S
Ayles, H
Hayes, RJ
HPTN 071 (PopART) Study Team
Item Type: Journal Article
Abstract: Background: HIV and Herpes simplex virus type-2 (HSV2) are strongly associated, although mechanisms are not fully understood. An HIV prevention trial allowed re-examination of this association at individual and community levels. Methods: HPTN 071 (PopART) evaluates a combination prevention intervention in 21 urban communities in Zambia and South Africa. To measure impact on HIV incidence, a cohort of ~2,000 adults (18-44y) was selected randomly from each community. Baseline data on socio-demographic characteristics, behaviour and HIV/HSV2 serology were used to examine the association between HIV and HSV2. At community-level, HIV prevalence was plotted against HSV2 prevalence. Results: 38,691 adults participated. HSV2 prevalence in women/men was 50%/22% (Zambia) and 60%/27% (South Africa). Estimated HSV2 incidence in those aged 18-24y was 8.06 (95%:CI:6.76-9.35) and 1.76 (95%CI:1.30-2.22) per 100/py in women and men, respectively. Six-fold higher odds of HIV were seen in HSV2-infected individuals in both sexes, after adjustment for confounders (Women:OR:6.66,95%CI: 6.07-7.31;Men:OR:6.57,95%CI:5.56-7.77). At community-level there was a strong linear relationship between HIV and HSV2 prevalence (ρ = 0.92,p<0.001). Conclusions: There was an exquisite association between these two infections, at individual and community levels, likely due partly to a powerful cofactor effect of HSV2 on HIV transmission. HSV2 control could contribute to HIV prevention.
Issue Date: 1-Aug-2018
Date of Acceptance: 5-Apr-2018
ISSN: 0022-1899
Publisher: Oxford University Press (OUP)
Start Page: 443
End Page: 452
Journal / Book Title: Journal of Infectious Diseases
Volume: 218
Issue: 3
Copyright Statement: © 2018 The Author(s). Published by Oxford University Press for the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: HPTN 071 (PopART) Study Team
11 Medical And Health Sciences
06 Biological Sciences
Publication Status: Published
Conference Place: United States
Online Publication Date: 2018-04-06
Appears in Collections:Department of Medicine

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