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|Title: ||The association between HSV-2 and HIV serostatus in pregnant women of known HIV serostatus attending new Mulago hospital antenatal clinic.|
|Authors: ||Nakubulwa, Sarah|
|Keywords: ||HIV serostatus|
Prevention of Mother to Child Transmission (PMTCT)
|Issue Date: ||2005 |
|Abstract: ||Title: Association between HSV-2 and HIV serostatus in pregnant women of known
HIV serostatus attending New Mulago Hospital antenatal clinic.
Introduction: Studies show that STIs such as HSV-2- increase the probability of HIV- I acquisition and enhance transmission by increasing susceptibility and infectiousness respectively The prevalence of HSV-2 and its association with HIV serostatus among women of known HIV serostatus in New Mulago Hospital ANC was not known.
Objective: To compare the seroprevalence of HSV-2 in HIV positive and HIV negative pregnant women attending antenatal clinic In New Mulago Hospital and to identify the factors associated with HSV-2 seropostivity
Study design: It was a case control study.
Study site: New Mulago Hospital Antenatal clinic
Study population: These were 50 cases (pregnant women who were HIV positive) and
200 controls (pregnant women who were HIV negative) and were aware of their HIV serostatus
Data collection and management: Data was collected in 2 parts, using a pretested interviewer administered semi structured questionnaire for socio-demographic characteristics, sexual and behavioral history and then a serological test for HSV-2 using an ELISA assay specific for IgG against viral glycoprotein G, specific to HSV-2. Data was checked daily for completeness, coded and entered into the computer using Epi info 6.04. Analysis was done using STATA statistical software.
Results: The overall proportion of HSV-2 among pregnant women of known HJV serostatus attending New Mulago Hospital was 67 2 % ( I 681250) [86% (43150) among the HIV positive cases and 62.5% ( I 251200) among the HIV negative controls] The odds of being HSV-2 seropositive was 3 7 times higher (95% CI was 1 58-8 61) in the HIV positive cases than the HIV negative controls the odds of HSV-2 was significantly increased to 5 32 (95% CI was 1 92- 14 73) among cases when adjustment was done age, education, marital status, religion, age at first sexual experience, lifetime partners, type of earning and whether or not the mother involved the partner in seeking treatment for sexually transmitted diseases. 55.8% of women with HSV-2 among the cases and 68.0% of those among the controls were married [(OR was 1.16 (0.62-2.20) the cases and 3.76 (1.01-14.01) in the controls]. All women with HSV-2 among the cases and 97.6% of those among the controls had more than one current sexual partner [The OR in the cases could not be got while that in the controls was 4.86 (1.25-18.92)]. Decision-making about seeking treatment for STIs without disclosure to sexual partners was associated with 4.86 risk (1.03-32.87) and 5.7 risk [(1.03-3 1.45) of being HSV-2 positive in the cases and control respectively. Having partners who had multiple sexual partners (2 or more wives) was associated with increased odds of being HSV-2 positive OR= 5.73 (0 63-5 1.68) and 5.82 (2.34-14 50) in cases and controls respectively Age at first sex of 20+years was associated with reduced risk of acquiring HSV-2 (OR 0.40 and 0.23) in the cases and controls respectively. Over 95% of the cases and controls had no history of genital ulcer. The results did not show a significant reduction of HSV-2 with condom use though condom use was high (76.6% in the cases and 73.6% in the controls).
Conclusions: The seroprevalence of HSV-2 was higher in the HIV positive cases than the HIV negative controls. The risk factors for HSV-2 in the cases and controls were being married, having a low socio-economic status, having a partner with 2 or more sexual partners and decision-making about seeking treatment for STIs without disclosure to sexual partner(s).
Recommendations: Routine counselling and screening for HSV-2 could be part of the antenatal care package. Provision of suppressive antlHSV-2 treatment to selected HSV-2 seropositive pregnant women treatment may prevent perinatal HSV-2 acquisition by the neonates and may reduce susceptibility to HIV. Universal routine anti HSV-2 prophylaxis to all HIV positive mothers irrespective of HSV-2 serology may enhance PMTCT.|
|Description: ||A thesis submitted in partial fulfillment of the requirements for the award of the Masters of Medicine Degree in Obstetrics and Gynaecology of Makerere University|
|Appears in Collections:||Theses & Dissertations (Health-Sciences)|
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