Herpes simplex 2 risk among women in a polygynous setting in rural West Africa

Halton, K; Ratcliffe, AA; Morison, L; West, B; Shaw, M; Bailey, R; Walraven, G; (2003) Herpes simplex 2 risk among women in a polygynous setting in rural West Africa. AIDS (London, England), 17 (1). pp. 97-103. ISSN 0269-9370 DOI: https://doi.org/10.1097/01.aids.0000042937.55529.05

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OBJECTIVES: To determine risk factors for herpes simplex 2 (HSV2) infection in women in a polygynous rural Gambian population. METHODS: Data from women who participated in a cross-sectional survey of reproductive health were matched to their own and, for women who had been or were married (ever-married), their spouses' data collected in a cross-sectional survey of fertility interests, including information on marital histories. RESULTS: Data were available on 150 never-married and 525 ever-married women. HSV2 prevalence was 16% amongst never-married women and 36% amongst ever-married women. For ever-married women, their own personal characteristics (age, ethnicity and genital cutting status) and events from their husbands' marriage history were important determinants of HSV2 infection. Women whose husbands married for the first time over age 35 were at greater risk than women whose husbands married by age 24 [odds ratio (OR) 2.72, 95% confidence interval (CI) 1.20-6.10]. Women whose husband reported interest in a new marriage were more likely to be HSV2 positive (OR 1.91, 95% CI 1.18-3.09). Women whose husbands were currently monogamous but had had previous marriages (OR 2.76, 95% CI 1.30-5.88) and women in currently polygynous marriages (OR 2.88, 95% CI 1.66-5.01) were three times as likely to be HSV2 positive as women who were their husband's only wife ever. CONCLUSION: Much transmission of HSV2 in this setting occurs within marriage where opportunity for personal protection is limited. High levels of transmission within marriage may undermine the impact of sexual behaviour change programmes aiming to reduce HSV2 and HIV incidence and complicate their evaluation.

Item Type: Article
Keywords: Adolescent, Adult, Age Factors, Cross-Sectional Studies, Female, Gambia/epidemiology, Herpes Genitalis/epidemiology/prevention & control/*transmission, Human, Male, Marital Status, Odds Ratio, Prevalence, Risk Factors, Rural Health, Sex Behavior, Support, Non-U.S. Gov't
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Tropical Epidemiology Group
PubMed ID: 12478074
Web of Science ID: 180369500013
URI: http://researchonline.lshtm.ac.uk/id/eprint/17103


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