Incidence of and temporal relationships between HIV, herpes simplex II virus, and syphilis among men who have sex with men in Bangkok, Thailand: an observational cohort

Details

• Alternative Title:
  BMC Infect Dis
• Personal Author:
  Thienkrua, Warunee ; Todd, Catherine S. ; Chonwattana, Wannee ; Wimonsate, Wipas ; Chaikummao, Supaporn ; Varangrat, Anchalee ; Chitwarakorn, Anupong ; van Griensven, Frits ; Holtz, Timothy H.
• Description:
  Background
  
  High HIV incidence has been detected among men who have sex with men (MSM) in Thailand, but the relationship and timing of HIV, herpes simplex virus 2 (HSV-2), and syphilis is unknown. This analysis measures incidence, temporal relationships, and risk factors for HIV, HSV-2, and syphilis among at-risk MSM in the Bangkok MSM Cohort Study.
  
  Methods
  
  Between April 2006 and December 2010, 960 men negative for HIV, HSV-2, and syphilis at entry enrolled and contributed 12–60 months of follow-up data. Behavioral questionnaires were administered at each visit; testing for HIV antibody was performed at each visit, while testing for syphilis and HSV-2 were performed at 12 month intervals. We calculated HIV, HSV-2, and syphilis incidence, assessed risk factors with complementary log-log regression, and among co-infected men, measured temporal relationships between infections with Kaplan-Meier survival analysis and paired t-test.
  
  Results
  
  The total number of infections and incidence density for HIV, HSV-2, and syphilis were 159 infections and 4.7 cases/100 PY (95 % Confidence Interval (CI): 4.0–5.4), 128 infections and 4.5/100 PY (95 % CI: 3.9–5.5), and 65 infections and 1.9/100 PY (95 % CI: 1.5–2.5), respectively. Among men acquiring >1 infection during the cohort period, mean time to HIV and HSV-2 infection was similar (2.5 vs. 2.9 years; p = 0.24), while syphilis occurred significantly later following HIV (4.0 vs. 2.8 years, p < 0.01) or HSV-2 (3.8 vs. 2.8 years, p = 0.04) infection. The strongest independent predictor of any single infection in adjusted analysis was acquisition of another infection; risk of syphilis (Adjusted Hazards Ratio (AHR) = 3.49, 95 % CI: 1.89–6.42) or HIV (AHR = 2.26, 95 % CI: 1.47–3.48) acquisition during the cohort was significantly higher among men with incident HSV-2 infection. No single independent behavioral factor was common to HIV, HSV-2, and syphilis acquisition.
  
  Conclusion
  
  HIV and HSV-2 incidence was high among this Thai MSM cohort. However, acquisition of HIV and co-infection with either HSV-2 or syphilis was low during the time frame men were in the cohort. Evaluation of behavioral risk factors for these infections suggests different risks and possible different networks.
  
  
• Subjects:
  Adolescent Adult Cohort Studies Coinfection Herpes Genitalis Herpes Simplex Herpesvirus 2, Human HIV-1 HIV Infections Homosexuality, Male Humans Incidence Male Middle Aged Risk Factors Syphilis Time Factors Young Adult

  More +
• Source:
  BMC Infect Dis. 16.
• Pubmed ID:
  27449012
• Pubmed Central ID:
  PMC4957431
• Document Type:
  Journal Article
• Place as Subject:
  Thailand
• Volume:
  16
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:61f77ac6ab21b875b2c4f6aa439821a96eb84cfd300ec732dcdcf6d04f311ba2
• Download URL:
  https://stacks.cdc.gov/view/cdc/41500/cdc_41500_DS1.pdf
• File Type:
  [PDF - 596.60 KB ]