Population-based seroprevalence of HSV-2 and syphilis in Andhra Pradesh state of India

Abstract

BackgroundUnderstanding the prevalence and risk factors for common causes of ulcerative genital disease in the general population would inform current STI syndromic management and HIV testing strategies in high HIV prevalence regions of India.MethodsPersons 15-49 years old from 32 rural and 34 urban clusters were sampled using a stratified random method to represent adults in the high HIV prevalence Guntur district in Andhra Pradesh state. Interviews were conducted and dry blood spots were collected on 12,617 study participants. Testing for HSV-2 and syphilis was performed.ResultsAdjusted HSV-2 and syphilis seroprevalence rates were 4.70% and 2.08% for men and 7.07% and 1.42% for women. For men, tattooing, >3 lifetime sex partners, tobacco use, and sex with men in the past 6 months were associated with HSV-2 or syphilis (ORs, 1.66-2.95, p < 0.05). Male circumcision was positively associated with HSV-2 infection (OR, 1.37, p = 0.028) though this could be due to residual confounding. In women, greater than one lifetime partner remained significantly associated with HSV-2 in multivariate analysis (OR, 2.61; 95% CI, 1.39-4.87). Among all behavioral risk factors and other covariates in women and men, HIV infection exhibited the strongest association with HSV-2 and syphilis (ORs, 8.2-14.2, p < 0.001). The proportion of individuals with HSV-2 who were HIV infected was less than the proportion with syphilis who were HIV infected (11.8% vs. 22.7%; p = 0.001).ConclusionsNearly one in four persons surveyed in this population-based study that were seroprevalent for syphilis, were also HIV infected. Common population risk factors for syphilis, HSV-2 and HIV and high rates of co-seroprevalence suggest that HIV testing, STI testing and service strategies for these would benefit from direct linkage in India.

Recent Trends of Sero-Prevalence of Syphilis in Patients Attending a Tertiary Care Centre in North India

“…10,11 This highlights the success of programs being implemented for prevention and management of STDs at STD clinics in our institute.…”

Genital herpes and HIV status: a clinical study

“…Syphilis and GH, both these GUDs are associated with multiple sex partners resulted in HIV positivity. 21 Patients with positive history of GUD had significantly higher number of partners, all had recurrent episodes and revealed higher number of episodes compared to those without history of GUD as in Table 9. This corroborates with both increased exposure to new infections and/or re-infection from infected non-treated partners as in Table 9.…”

Re-Emergence of HIV Infection and Syphilis Among Men Who Have Sex with Men

“…The little information available on rates of syphilis in India show an incidence rate of 5.4 per 100 person years in a sexually transmitted disease clinic in India from 1993-2000 and prevalence rates as high as 21.9% amongst a convenience sample of long-distance truck drivers in 2000 (Gawande et al, 2000, & Reynolds et al, 2006, as cited in Schneider et al, 2010. A recent study (Schneider et al, 2010) carried out in Andhra Pradesh in the general population (6.235 men and 6.382 women study participants) showed prevalence rates of 2.08% for men and 1.42% for woman; nearly one in four persons surveyed that were seropositive for syphilis were also HIV infected. 85 men, that declared to have sex with men > 6 months ago, showed a syphilis prevalence of 2.4% while other 47, that declared own homosexuality within last 6 months, showed a prevalence of 6.4%.…”