Seroprevalence and correlates of herpes simplex virus type 2 among urban Tanzanian women

Background: Data on herpes simplex virus type 2 (HSV-2) among women in the general population of developing countries are limited. Goals: The goal of the study was to determine the seroprevalence of HSV-2 and to identify clinical, demographic, and behavioral correlates among women attending primary health care clinics. Study Design: This was a cross-sectional survey of 382 randomly chosen women aged 15 to 49 years. Results: The seroprevalence of HSV-2 was 39%. Only 2% had a history of genital herpes. HSV-2 was associated with antibody to HIV-1 (OR = 2.3 [CI, 1.1-4.7% syphilis (OR = 4.7 [CI, 1.4-4.7]), and genital ulcers (OR = 9.7 [CI 2.5-36.9]). Age, sexual debut, number of sex partners, and history of spontaneous abortion were found to be significantly associated with HSV-2. Eighty-two percent of the women with genital ulcers were HSV-2-seropositive, while syphilis accounted for 6% of cases. HSV-2 may thus be the most common cause of genital ulcers in this population. Conclusion: In view of the high HSV-2 seroprevalence and its association with HIV-1 and genital ulcers, integration of HSV-2 therapeutic management in STD syndromic algorithms is recommended. Counseling on symptom recognition, asymptomatic shedding, and preventive measures is needed.