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"were interviewed, and tested for HIV and RTIs every 3 months for 15 to 24 months. They received HIV risk reduction counseling, male condoms, and treatment for curable RTIs. Despite HIV risk reduction counseling and regular screening and treatment for RTIs, the HIV incidence did not decline during the study. Positive HSV-2 serostatus at baseline (hazard ratio [HR] = 3.69, 95% confidence interval = 2.45-5.55), incident HSV-2 (HR = 5.35, 3.06-9.36), incident Neisseria gonorrhoeae (HR = 5.46, 3.41-8.75), and altered vaginal flora during the study (bacterial vaginosis [BV]: HR = 2.12, 1.50-3.01; and intermediate flora: HR = 2.02, 1.39-2.95) were independently associated with HIV acquisition after controlling for demographic and behavioral covariates and other RTIs (Treponema pallidum, Chlamydia trachomatis, Trichomonas vaginalis, and vaginal yeasts). For N. gonorrhoeae, C. trachomatis, T vaginalis, and vaginal yeasts,. the risk of HIV acquisition increased when the infection was identified at the visit before the HIV-detection visit or with the duration of infection. attributable risk percent (PAR%) calculations show that HSV-2 contributes most to acquisition of new HIV infections (50.4% for baseline HSV-2 and 7.9% for incident HSV-2), followed by altered vaginal flora (17.2% for bacterial vaginosis and 11.8% for intermediate flora)," wrote J.H.H.M. Vandewijgert and colleagues, University of Amsterdam.

The researchers concluded: "A substantial proportion of new HIV infections in Zimbabwean and Ugandan women are attributable to RTIs, particularly HSV-2 and altered vaginal flora.."

Vandewijgert and colleagues published their study in Sexually Transmitted Diseases (Disentangling Contributions of Reproductive Tract Infections to HIV Acquisition in African Women. Sexually Transmitted Diseases, 2009;36(6):357-364).

For additional information, contact J.H.H.M. Vandewijgert, University of Amsterdam, Academy Med Center, Center Poverty Related Communicable Diseases, Meibergdreef 9 T0-120, POB 22700, NL-1100 DE Amsterdam, Netherlands.

The publisher of the journal Sexually Transmitted Diseases can be contacted at: Lippincott Williams & Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA.

Keywords: Netherlands, HIV/AIDS, AIDS, Acquired Immunodeficiency Syndrome, Bacterial Vaginosis, Clinical Trial Research, Gonorrhea, Gynecology, HIV, HSV-2, Herpesvirus, Human Immunodeficiency Virus, Infectious Disease, Sexually Transmitted Disease, Virology, Women's Health, University of Amsterdam.

This article was prepared by Virus Weekly editors from staff and other reports. Copyright 2009, Virus Weekly via NewsRx.com.