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Thienkrua W, Todd CS, Chonwattana W, Wimonsate W, Chaikummao S, Varangrat A, Chitwarakorn A, van Griensven F, Holtz TH. Incidence of and temporal relationships between HIV, herpes simplex II virus, and syphilis among men who have sex with men in Bangkok, Thailand: an observational cohort. BMC Infect Dis 2016; 16:340. [PMID: 27449012 PMCID: PMC4957431 DOI: 10.1186/s12879-016-1667-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 06/27/2016] [Indexed: 11/11/2022] Open
Abstract
Background High HIV incidence has been detected among men who have sex with men (MSM) in Thailand, but the relationship and timing of HIV, herpes simplex virus 2 (HSV-2), and syphilis is unknown. This analysis measures incidence, temporal relationships, and risk factors for HIV, HSV-2, and syphilis among at-risk MSM in the Bangkok MSM Cohort Study. Methods Between April 2006 and December 2010, 960 men negative for HIV, HSV-2, and syphilis at entry enrolled and contributed 12–60 months of follow-up data. Behavioral questionnaires were administered at each visit; testing for HIV antibody was performed at each visit, while testing for syphilis and HSV-2 were performed at 12 month intervals. We calculated HIV, HSV-2, and syphilis incidence, assessed risk factors with complementary log-log regression, and among co-infected men, measured temporal relationships between infections with Kaplan-Meier survival analysis and paired t-test. Results The total number of infections and incidence density for HIV, HSV-2, and syphilis were 159 infections and 4.7 cases/100 PY (95 % Confidence Interval (CI): 4.0–5.4), 128 infections and 4.5/100 PY (95 % CI: 3.9–5.5), and 65 infections and 1.9/100 PY (95 % CI: 1.5–2.5), respectively. Among men acquiring >1 infection during the cohort period, mean time to HIV and HSV-2 infection was similar (2.5 vs. 2.9 years; p = 0.24), while syphilis occurred significantly later following HIV (4.0 vs. 2.8 years, p < 0.01) or HSV-2 (3.8 vs. 2.8 years, p = 0.04) infection. The strongest independent predictor of any single infection in adjusted analysis was acquisition of another infection; risk of syphilis (Adjusted Hazards Ratio (AHR) = 3.49, 95 % CI: 1.89–6.42) or HIV (AHR = 2.26, 95 % CI: 1.47–3.48) acquisition during the cohort was significantly higher among men with incident HSV-2 infection. No single independent behavioral factor was common to HIV, HSV-2, and syphilis acquisition. Conclusion HIV and HSV-2 incidence was high among this Thai MSM cohort. However, acquisition of HIV and co-infection with either HSV-2 or syphilis was low during the time frame men were in the cohort. Evaluation of behavioral risk factors for these infections suggests different risks and possible different networks.
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Affiliation(s)
- Warunee Thienkrua
- HIV/STD Research Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, DDC 7 Building, 4th floor, Ministry of Public Health, Soi 4, Nonthaburi, 11000, Thailand
| | - Catherine S Todd
- FHI 360 Asia-Pacific Regional Office, 9th Floor, Tower 3, Sindhorn Building, 130-132 Wireless Road, Lumpini, Phatumwan, Bangkok, 10330, Thailand.
| | - Wannee Chonwattana
- HIV/STD Research Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, DDC 7 Building, 4th floor, Ministry of Public Health, Soi 4, Nonthaburi, 11000, Thailand
| | - Wipas Wimonsate
- HIV/STD Research Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, DDC 7 Building, 4th floor, Ministry of Public Health, Soi 4, Nonthaburi, 11000, Thailand
| | - Supaporn Chaikummao
- HIV/STD Research Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, DDC 7 Building, 4th floor, Ministry of Public Health, Soi 4, Nonthaburi, 11000, Thailand
| | - Anchalee Varangrat
- HIV/STD Research Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, DDC 7 Building, 4th floor, Ministry of Public Health, Soi 4, Nonthaburi, 11000, Thailand
| | - Anupong Chitwarakorn
- Department of Disease Control, DDC 7 Building, 1st Floor Ministry of Public Health, Nonthaburi, 11000, Thailand
| | - Frits van Griensven
- Thai Red Cross HIV Research Center, 104 Rajdamri Road, Pathum Wan, Bangkok, 10330, Thailand.,Division of Preventive Medicine and Public Health, School of Medicine, University of California-San Francisco, 50 Beale Street, Ste 1200, San Francisco, 94105, CA, USA
| | - Timothy H Holtz
- HIV/STD Research Program, Thailand Ministry of Public Health - U.S. Centers for Disease Control and Prevention Collaboration, DDC 7 Building, 4th floor, Ministry of Public Health, Soi 4, Nonthaburi, 11000, Thailand.,Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, 30329, GA, USA
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Wang H, Reilly KH, Smith MK, Brown K, Jin X, Xu J, Ding G, Zang C, Wang J, Wang N. Herpes simplex virus type 2 incidence and associated risk factors among female sex workers in a high HIV-prevalence area of China. Int J STD AIDS 2013; 24:441-6. [PMID: 23970745 DOI: 10.1177/0956462412472800] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Herpes simplex virus type 2 (HSV-2) can contribute to the spread of HIV. From March 2006 to November 2009, female sex workers (FSWs) in Yunnan, China were recruited into an open cohort study to determine incidence and risk factors for HSV-2 acquisition. Participants were interviewed and tested for HSV-2 and other sexually transmitted infections (STIs) every six months. A multivariate Cox proportional hazards regression model with time-dependent variables was used to measure associations with HSV-2 acquisition. In 3.5 years, 83 incident cases of HSV-2 infection were diagnosed, yielding an overall incidence of 21.9 per 100 person years (PY) (95% confidence interval [CI], 17.8-26.3). Working in higher risk commercial sex venues, current Neisseria gonorrhoeae infection, age of sexual debut <18 years and lack of a regular sex partner were independent factors associated with HSV-2 acquisition. The high incidence of HSV-2 suggests that prevention methods for HIV/STI control are urgently needed.
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Affiliation(s)
- H Wang
- Chinese Center for Disease Control and Prevention, 27 Nanwei Rd, Beijing 100050
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