Halton Kate, Ratcliffe Amy A, Morison Linda, West Beryl, Shaw Matthew, Bailey Robin, Walraven Gijs
Medical Research Council Laboratories, Farafenni and Fajara, The Gambia and the London School of Hygiene and Tropical Medicine, London, UK.
AIDS. 2003 Jan 3;17(1):97-103. doi: 10.1097/00002030-200301030-00013.
To determine risk factors for herpes simplex 2 (HSV2) infection in women in a polygynous rural Gambian population.
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.
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.
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.
确定冈比亚农村一夫多妻制人群中女性感染单纯疱疹病毒2型（HSV2）的风险因素。
将参与生殖健康横断面调查的女性数据与其自身数据进行匹配，对于已婚或曾婚（曾有婚姻经历）的女性，将其数据与其配偶在生育意愿横断面调查中收集的数据进行匹配，包括婚姻史信息。
有150名未婚女性和525名曾婚女性的数据。未婚女性中HSV2感染率为16%，曾婚女性中为36%。对于曾婚女性，其个人特征（年龄、种族和是否接受过生殖器切割）以及丈夫的婚姻史事件是HSV2感染的重要决定因素。丈夫首次结婚时年龄超过35岁的女性比丈夫在24岁前结婚的女性感染风险更高[比值比（OR）2.72，95%置信区间（CI）1.20 - 6.10]。丈夫表示有再婚意愿的女性更有可能HSV2呈阳性（OR 1.91，95% CI 1.18 - 3.09）。丈夫目前实行一夫一妻制但有过婚史的女性（OR 2.76，95% CI 1.30 - 5.88）以及目前处于一夫多妻制婚姻中的女性（OR 2.88，95% CI 1.66 - 5.01）HSV2呈阳性的可能性是丈夫唯一妻子的女性的三倍。
在这种情况下，HSV2的大量传播发生在婚姻关系中，而个人防护的机会有限。婚姻内的高传播水平可能会削弱旨在降低HSV2和HIV发病率的性行为改变项目的效果，并使其评估变得复杂。
