AEGiS-15IAC: High HSV-2 prevalence among IDUs and their sex partners in a setting with high HIV prevalence in IDUs: A window of opportunity to prevent further transmission of HIV to women.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

High HSV-2 prevalence among IDUs and their sex partners in a setting with high HIV prevalence in IDUs: A window of opportunity to prevent further transmission of HIV to women.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. ThOrC1370)

Panda S, Kumar SM, Grosskurth H, Mahalingam P, Balakrishnan P, Kantesh B, Tambi PA, Rangaiyan G, Flessenkaemper S
Sahai Trust, Chennai, India

BACKGROUND: Transmission of HIV from IDUs to their sexual partners is rarely addressed in targeted interventions for IDUs. Sexually transmitted infections are known to enhance HIV transmission, however little is known about their prevalence and contribution to HIV transmission from and to drug users. The objectives of our study was to estimate the current prevalence of HIV and STIs in IDUs and their wives/regular female sex partners in Chennai, Southern India, to design future interventions.

METHOD: A cross sectional study was conducted in Central Chennai in 2003. Peer and social outreach workers identified the participants in the community using a snowballing technique. 452 participants (226 IDUs, 202 wives & 24 regular female sex partners) were recruited. After interviews, sera were taken and investigated using HSV-2 specific ELISA, RPR and TPHA tests for syphilis and two different HIV 1/2 ELISAs.

RESULTS: 30% (68/226) of the IDUs and 16% (11/68) of the female sexual partners of the HIV positive IDUs were HIV positive. Concordance for HIV positive test results was 5% in our study couples and discordance for HIV test result was found in 25%. The remaining 70% of the couples were not HIV infected. Prevalence of active Syphilis was 3% in both sexes, HSV-2-antibody prevalence was high at 40% among IDUs and 39% in women; only 23% of the couples recruited in the study were concordant for HSV-2 positive antibodies. Conclusion Our data indicate a high rate of exposure of the study population to HSV-2 infection. Endogenous reactivation of latent HSV-2 infection may enhance HIV transmission. Discordance for both HIV and HSV-2, points at the high potential for future infection of the spouse and acceleration of HIV transmission among the couples. Biologic interventions in addition to behavior change communication and harm reduction activities are therefore urgently needed to curb further transmission of HIV and HSV-2 in this population group.

Keywords: AEGIS, Prevalence, HIV Seropositivity, Acquired Immunodeficiency Syndrome, Coitus, Sex, Cross-Sectional Studies, Sexual Partners, Syphilis, India, Humans, Female, transmission, epidemiology

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