HIV infection among youth in a South African mining town is associated with herpes simplex virus-2 seropositivity and sexual behaviour

Objectives: To determine the seroprevalence of HIV and herpes simplex virus -2 (HSV-2) by age and gender among young people aged 14-24 years in a South African town and to identify risk factors for HIV infection. Design: A community-based, cross-sectional study was conducted on a random sample of men (n = 723) and women (n = 784) living in a township in the Car letonville district of South Africa. Methods: Potential demographic and behavioural risk factors associated with HIV were recorded by questionnaire and biological tests were performed on serum and urine. Data analysis was performed using multivariate logistic re gression. Results: Among men and women the prevalence of HIV infection was 9.4 and 34 .4%, respectively, and of positive HSV-2 serology was 17.0 and 53.3%, respe ctively. Among 24-year-old women the prevalence of HIV was 66.7% [95% confi dence interval (CI), 54.6-77.3%]. HSV-2 seropositivity was a strong indepen dent risk factor for HIV infection with odds ratios of 5.3 (95% CI, 2.7-10. 3) for men and 8.4 (95% CI, 4.9-14.2) for women. There was no independent e ffect of age at first sex or serological markers of other sexually transmit ted infections on HIV infection. Conclusions: HIV infection among young women increases rapidly after the on set of sexual activity and reaches extremely high levels by 24 years of age . These findings suggest that rates of HIV transmission from men to women a re high and that HSV-2 plays a major role in the spread of HIV in this popu lation. (C) 2001 Lippincott Williams & Wilkins.