Abstract:
Background: Evidence suggests that a substantial proportion of new HIV infections in African
countries are associated with herpes simplex virus type 2 (HSV-2). Thus, the magnitude of HSV-2
infection in an area may suggest the expected course of the HIV epidemic. We determined
prevalence of genital herpes, syphilis and associated factors among pregnant women from a remote
rural Tanzanian community that has a low but increasing HIV prevalence.
Methods: We analysed 1296 sera and responses to a standard structured questionnaire collected
from pregnant women aged between 15–49 years, attending six different antenatal clinics within
rural Manyara and Singida regions in Tanzania. Linked anonymous testing (with informed consent)
of the serum for specific antibodies against HSV-2 was done using a non-commercial peptide- 55
ELISA. Antibodies against syphilis were screened by using rapid plasma reagin (RPR) and reactive
samples confirmed by Treponema pallidum haemagglutination assay (TPHA).
Results: Previous analysis of the collected sera had shown the prevalence of HIV antibodies to be
2%. In the present study the prevalence of genital herpes and syphilis was 20.7% (95% CI: 18.53–
23.00) and 1.6% (95% CI: 1.03–2.51), respectively. The presence of HSV-2 antibodies was
associated with polygamy (OR 2.2, 95% CI: 1.62 – 3.01) and the use of contraceptives other than
condoms (OR 1.7, 95% CI: 1.21 – 2.41). Syphilis was associated with reporting more than one
lifetime sexual partner (OR 5.4, 95% CI: 1.88 – 15.76) and previous spontaneous abortion (OR 4.3,
95% CI: 1.52–12.02).
Conclusion: The low prevalence of HIV infection offers a unique opportunity for strengthening
HIV prevention in a cost-effective manner. The identification and control of other prevalent curable
STIs other than syphilis and specific intervention of HSV-2 in specific populations like pregnant
women would be one among approaches towards preventing incident HIV infections.
