Mehta S D, Moses S, Agot K, Agingu W, Parker C, Ndinya-Achola J O, Bailey R C
Department of Epidemiology and Biostatistics, University of Illinois Chicago School of Public Health, Illinois, USA.
Sex Transm Infect. 2008 Feb;84(1):42-8. doi: 10.1136/sti.2007.025718. Epub 2007 Sep 12.
To identify factors associated with herpes simplex virus type 2 (HSV-2) infection among men aged 18-24 in Kisumu, Kenya.
Baseline data from a randomised trial of male circumcision were analysed. Participants were interviewed for sociodemographic and behavioural risks. The outcome was HSV-2 by antibody status. Risk factors were considered singly and in combination through logistic regression models.
Among 2771 uncircumcised men, 766 (27.6%; 95% confidence interval (CI) 26.0% to 29.3%) tested antibody positive for HSV-2. The median age at first sex was 16 years, and the median number of lifetime sexual partners was four. HSV-2 seroprevalence increased from 19% among 18-year-olds to 43% among 24-year-olds (p<0.001). In multivariable analysis, statistically significant risks for infection were increasing age (adjusted odds ratio (AOR) = 1.22-2.58), being married or having a live-in female partner (AOR = 1.80; 95% CI 1.28 to 2.53), preferring "dry" sex (AOR = 1.39; 95% CI 1.14 to 1.69), reported penile cuts or abrasions during sex (AOR = 1.58; 95% CI 1.32 to 1.91), increasing lifetime sex partners (multiple response categories; AORs ranging from 1.65 to 1.97), and non-student occupation (multiple response categories; AORs ranging from 1.44 to 1.93). Risk decreased with reported condom used at last sex (AOR = 0.82; 95% CI 0.68 to 0.99).
Primary prevention efforts should be initiated at an early age. The same behavioural interventions used currently for HIV prevention-abstinence, reducing the number of sex partners and increasing condom use-should be effective for HSV-2 prevention.
确定肯尼亚基苏木18至24岁男性中与2型单纯疱疹病毒（HSV-2）感染相关的因素。
对一项男性包皮环切随机试验的基线数据进行分析。就社会人口统计学和行为风险对参与者进行访谈。结局指标为HSV-2抗体状态。通过逻辑回归模型单独及综合考虑风险因素。
在2771名未行包皮环切的男性中，766人（27.6%；95%置信区间（CI）26.0%至29.3%）HSV-2抗体检测呈阳性。首次性行为的中位年龄为16岁，终身性伴侣的中位数量为4个。HSV-2血清阳性率从18岁人群中的19%升至24岁人群中的43%（p<0.001）。在多变量分析中，感染的统计学显著风险因素包括年龄增加（调整优势比（AOR）=1.22 - 2.58）、已婚或有同居女性伴侣（AOR = 1.80；95% CI 1.28至2.53）、偏好“干性性行为”（AOR = 1.39；95% CI 1.14至1.69）、报告在性行为期间阴茎有切口或擦伤（AOR = 1.58；95% CI 1.32至1.91）、终身性伴侣数量增加（多个反应类别；AOR范围为1.65至1.97）以及非学生职业（多个反应类别；AOR范围为1.44至1.93）。风险随报告的最后一次性行为使用避孕套而降低（AOR = 0.82；95% CI 0.68至0.99）。
应在早年开展一级预防工作。目前用于预防艾滋病毒的相同行为干预措施——禁欲、减少性伴侣数量和增加避孕套使用——对预防HSV-2应同样有效。
