Partner-concurrency associated with herpes simplex virus 2 infection in young South Africans

Whilst much is known about the individual-level risk factors for herpes simplex virus 2 (HSV-2) infection, little is known about why only some populations develop generalized HSV-2 epidemics. This study aims to assess the extent to which partner-concurrency (a factor which operates at both the partnership- and network-level) may be responsible. We utilized multivariate logistic regression to analyse the relationship between HSV-2 seropositivity and potential risk factors in data from a representative cross-sectional survey of 14-24 year olds from a township in South Africa conducted in 1999. The overall prevalence of HSV-2 was 53.3% amongst women and 17% amongst men. For men, four factors remained significantly associated with HSV-2 infection in the multivariate regression analysis: total number of sex acts, being a migrant labourer, Zulu ethnicity and being human immunodeficiency virus (HIV) positive. For women, eight factors were associated with HSV-2 infection: increasing age, partner-concurrency (having a partner who had other partners), an older partner, total number of sex acts, using hormonal contraception, Xhosa ethnicity, syphilis seropositivity and being HIV positive. We conclude that partner-concurrency is associated with increased HSV-2 seropositivity in women.