THE HIGH PREVALENCE OF GENITAL HERPES AMONG PATIENTS WITH GENITAL ULCER DISEASE IN UGANDA

Background: Genital ulcer disease is a risk factor for transmission of human immunodeficiency virus. One-hundred consecutive Ugandan patient s (median age, 25 years) with genital ulcer disease were examined to d etermine the prevalence of genital herpes and its relationship to huma n immunodeficiency virus seropositivity. Goal of this Study. To improv e management, prevention, and control of genital ulcer disease, thus r educing human immunodeficiency virus infections attributable to genita l ulcer disease. Study Design: This was a prevalence study of genital herpes in a consecutive sample of an urban sexually transmitted diseas e clinic population. Results: Forty-nine percent (48/98) of the patien ts had genital herpes (36% by direct fluorescent antigen and 13% by hi story of recurrent vesicles). There was a trend toward larger lesions in patients who were human immunodeficiency virus seropositive. Twelve percent (11/89) of patients had syphilis, and 30% (30/100) remained s exually active, despite the presence of active genital ulcer disease. Sixty-five percent of 89 patients tested had antibodies to human immun odeficiency virus. Conclusions: Genital herpes is a common cause of ge nital ulcer disease in patients attending sexually transmitted disease clinics in Uganda, and herpes ulcers may be more extensive among thos e who are infected with human immunodeficiency virus.