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15 November 2006

Volume 194, Number 10
The Journal of Infectious Diseases 2006;194:1459–1466
© 2006 by the Infectious Diseases Society of America. All rights reserved.
0022-1899/2006/19410-0016$15.00
DOI: 10.1086/508548
MAJOR ARTICLE

Association of Herpes Simplex Virus Type 2 Infection and Syphilis with Human Immunodeficiency Virus Infection among Men Who Have Sex with Men in Peru

Javier R. Lama,1

Aldo Lucchetti,1

Luis Suarez,2

Victor A. Laguna‐Torres,3

Juan V. Guanira,2

Monica Pun,2

Silvia M. Montano,3

Connie L. Celum,4

Jean K. Carr,5

Jorge Sanchez,1

Christian T. Bautista,3,a and

Jose L. Sanchez,3,6 for the

Peruvian HIV Sentinel Surveillance Working Groupb

1Asociación Civil Impacta Salud y Educación, 2Direction of General Epidemiology, Ministry of Health of Peru, and 3US Naval Medical Research Center Detachment, Lima, Peru; 4Departments of Medicine and Epidemiology, University of Washington, Seattle; 5Division of Epidemiology and Prevention, Institute of Human Virology, Baltimore, and 6Department of Defense Global Emerging Infections Surveillance and Response System, Walter Reed Army Institute of Research, Silver Spring, Maryland

Background.We evaluated associations between human immunodeficiency virus (HIV) infection, herpes simplex virus type 2 (HSV‐2) infection, and syphilis among men who have sex with men (MSM) in Peru.

Methods.A surveillance survey of 3280 MSM was conducted; sexual behavior was assessed with a structured computer‐assisted self‐interview, and serum antibody testing was performed for HIV, HSV‐2, and Treponema pallidum.

Results.HIV, HSV‐2, and syphilis seroprevalences of 13.9%, 46.3%, and 13.4% were detected, respectively. HSV‐2 seroprevalence was twice as high in HIV‐infected subjects (80.5%) than it was in HIV‐uninfected subjects (40.8%) ( ), and HSV‐2 seropositivity (adjusted odds ratio [AOR], 5.66) was found to be strongly associated with HIV infection. In addition, homosexual self‐definition (AOR, 3.12), exchange of sex for money (AOR, 1.61), unprotected sex (no condom) (AOR, 2.81), history of sex work (AOR, 1.89), oral receptive sex (AOR, 1.43), and cocaine use before/during sex (AOR, 2.53) within the preceding 6 months, as well as such sexually transmitted infections (STIs) and STI syndromes as proctitis (AOR, 2.80), genital ulcer disease (GUD) (AOR, 2.06), prior syphilis (AOR, 2.64), genital warts (AOR, 1.70), and self‐reported STIs within the preceding 6 months (AOR, 1.61), were also found to be significant predictors of HIV infection.

Conclusions.We found a strong association between HSV‐2 seropositivity and HIV infection. Intervention measures against GUD due to HSV‐2 infection and syphilis, such as routine testing, early detection, HSV‐2 suppressive treatment, and condom distribution, need to be enhanced as part of STI prevention strategies at a national level to effectively reduce HIV infection among MSM in Peru.

Received 9 June 2006; accepted 22 July 2006; electronically published 10 October 2006.

Reprints or correspondence: Dr. Jose L. Sanchez, Dept. of Defense Global Emerging Infections Surveillance and Response System, Walter Reed Army Institute of Research, 503 Robert Grant Ave., Silver Spring, MD 20910‐7500 ().

Cited by

Aaron AR Tobian, Thomas C Quinn. (2009) Herpes simplex virus type 2 and syphilis infections with HIV: an evolving synergy in transmission and prevention. Current Opinion in HIV and AIDS 4:4, 294-299
Online publication date: 1-Aug-2009.
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Alberto M. La Rosa, Joseph R. Zunt, Jesus Peinado, Javier R. Lama, Thanh G. N. Ton, Luis Suarez, Monica Pun, Cesar Cabezas, and Jorge Sanchez, for the Peruvian HIV Sentinel Surveillance Working Group. (2009) Retroviral Infection in Peruvian Men Who Have Sex with Men. Clinical Infectious Diseases 49:1, 112-117
Online publication date: 1-Jul-2009.
Abstract-Full Text-PDF Version (239 kB)
Jorge Sanchez, Javier R Lama, Jesus Peinado, Andres Paredes, Aldo Lucchetti, Kevin Russell, Tadeusz Kochel, Jose L Sebastian. (2009) High HIV and Ulcerative Sexually Transmitted Infection Incidence Estimates Among Men Who Have Sex With Men in Peru: Awaiting for an Effective Preventive Intervention. JAIDS Journal of Acquired Immune Deficiency Syndromes 51:Supplement 1, S47-S51
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Online publication date: 1-Apr-2009.
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Juan V Guanira, Corey Casper, Javier R Lama, Rhoda Morrow, Silvia M Montano, Patricia Caballero, Luis Suárez, William L H Whittington, Anna Wald, Jorge Sanchez, Connie Celum. (2009) Prevalence and Correlates of Human Herpesvirus 8 Infection Among Peruvian Men Who Have Sex With Men. JAIDS Journal of Acquired Immune Deficiency Syndromes 49:5, 557-562
Online publication date: 1-Jan-2009.
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Kelika Anne Konda, Andres G. Lescano, Elli Leontsini, Percy Fernandez, Jeffrey D. Klausner, Thomas J. Coates, Carlos F. Cáceres, . (2008) High Rates of Sex with Men among High-Risk, Heterosexually-Identified Men in Low-Income, Coastal Peru. AIDS and Behavior 12:3, 483-491
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  • Potential conflicts of interest: none reported.

    Financial support: Ministry of Health of Peru; Asociación Civil Impacta Salud y Educación; US National Institutes of Health; Fogarty International Center, University of Washington AIDS International Training and Research (grant D43‐TW00007); US Naval Medical Research Center (work unit 62787A.873.H.B0002); US Military HIV Research Program, Walter Reed Army Institute of Research (work unit 62787A.S17.H.B0002).

    The opinions and assertions made by the authors do not reflect the official position or opinion of the government of the Republic of Peru, the Ministry of Health of Peru, the US Departments of the Army or Navy, or of any of the other organizations listed.

  • Present affiliation: US Military HIV Research Program, Walter Reed Army Institute of Research, Rockville, Maryland.

  • Study group members are listed after the text.

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