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Double whammy: herpes and HIV among young people in South Africa

HIV has spread rapidly in South Africa since 1990. Studies suggest that herpes simplex virus type two (HSV-2) can increase susceptibility to HIV infection. Young people are particularly at risk of contracting HIV in many developing countries. Does HSV-2 increase the risk of HIV among young people? What implications does this have for HIV-prevention efforts targeted at this age group?

An international team of researchers set out to examine the association between HIV and HSV-2 among young people in a South African township. They surveyed more than 1500 sexually active men and women aged 14 to 24 in the Carltonville district, which contains the largest gold-mining complex in the world. They also tested participants for a number of sexually transmitted infections (STIs) including HIV.

The survey revealed that:

The overall prevalence of HIV is 22.4 percent and of HSV-2 is 35.4 percent. Rates are significantly higher among women than men.
The prevalence of both infections increases with the number of lifetime partners, particularly among women.
HIV prevalence is four times greater among married men than men who have never been married. Marriage and motherhood are also risk factors for women.
HSV-2 infection is the most significant factor associated with HIV for both men and women.
Other risk factors for men are syphilis, lack of secondary school education and not washing the penis with soap at least once a day.
For women, other risk factors are gonorrhoea infection, age, type of housing, number of sexual partners and sexual relationship with a mineworker.

Implications for HIV prevention policies among young people in South Africa include:

The prevalence of HIV infection is very high in Carltonville. There is an urgent need to assess the situation in other areas of South Africa.
Further studies are needed to clarify the role of HSV-2 in the spread of HIV.
High levels of infection among young women who report only one or two sexual partners suggests that HIV transmission rates from men to women are far higher than in developed countries.
HIV prevention in this population should include treatment of curable STIs, education campaigns about the symptoms and spread of genital herpes, strong promotion of condom use and emphasis on the importance of washing the penis regularly.
School-based prevention programmes are also needed.

Source(s):
'HIV infection among youth in a South African mining town is associated with herpes simplex virus-2 seropositivity and sexual behaviour' by Bertran Auvert et al., AIDS 15 (2001)

Funded by: UK Department for International Development; USAID; Agence Nationale de Recherche Contre le SIDA; Institut National de la Santé et de la Recherche Médicale; Glaxo-Wellcome Research and Development UK; UNAIDS; The Gauteng Department of Health; Council for Scientific and Industrial Research; South African Institute for Medical Research; London School of Economics; Progressus.

id21 Research Highlight: 27 February 2002

Further Information:
Bertran Auvert
INSERM U88
14 rue du Val d'Osne
94415 Saint-Maurice Cedex
France

Contact the contributor: bertran.auvert@paris-ouest.univ-paris5.fr

INSERM, France

Catherine Campbell
Social Psychology
London School of Economic and Political Science
Houghton Street
London WC2A 2AE
UK

Tel: +44 (0)20 7955 7701
Fax: +44 (0)20 7955 7565
Contact the contributor: c.campbell@lse.ac.uk

London School of Economics, UK

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