STI Treatment for HIV Prevention  MOAC1
Type:
Oral abstract session Back
Venue: Bayside Auditorium A
Time: 11:00 - 12:30, Monday, 23.07.2007
Code: MOAC1
Co-Chairs: Sandra Lehrman, United States
John Millan, Papua New Guinea

    Presentations in this session:
11:00
MOAC101
Abstract
Powerpoint (204 KB)		Herpes simplex virus type 2 infection among U.S. military service members; public health implications and opportunities for HIV prevention
Presented by Christian T Bautista, United States
Bautista C.T.1, Singer D.E.1, O'Connell R.1, Agan B.2, Malia J.1, Sanchez J.L.3, Peel S.1, Michael N.L.1, Scott P.T.1
1U.S. Military HIV Research Program/Division of Retrovirology at the Walter Reed Army Institute of Research (WRAIR), Rockville, MD, United States, 2Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, United States, 3DoD Global Emerging Infections Surveillance & Response System, WRAIR, Silver Spring, MD, United States

11:15
MOAC102
Abstract
Powerpoint (120 KB)		Co-infection of STDs with HIV among men who have sex with men in Beijing, China
Presented by Xiaoyan Zhang, China
Zhang X.X.1, Wang C.1, Wang H.1, Li D.1, Zhang X.Y.2, Shao Y.3
1Chaoyang District CDC, Beijing, China, 2Chinese National Center for AIDS/STD Control and Prevention, Virology and Immunology, Beijing, China, 3State Key Laboratory for Infectious Disease Prevention and Control,Chinese National Center for AIDS/STD Control and Prevention, Beijing, China

11:30
MOAC103
Abstract		Infection with trichomonas vaginalis is associated with increased risk for HSV-2 infection among married women in Mysore, India
Presented by Purnima Madhivanan, United States
Madhivanan P.1, Krupp K.2, Chandrasekaran V.3, Karat C.3, Arun A.4, Klausner J.5, Reingold A.6
1University of California, Epidemiology, Albany, United States, 2Asha Kirana Hospital, Mysore, India, 3CSI Holdsworth Memorial hospital, Obstetrics and Gynecology, Mysore, India, 4Vikram Hospital, Mysore, India, 5University of California, Medicine, San Francisco, United States, 6University of California, Epidemiology, Berkeley, United States

11:45
MOAC104
Abstract		Impact of HSV-2 suppressive therapy on HIV incidence in HSV-2 seropositive women: a randomised controlled trial in Tanzania
Presented by Deborah Watson-Jones, Tanzania, United Republic of
Watson-Jones D.1, Rusizoka M.1, Weiss H.2, Mugeye K.1, Baisley K.3, Changalucha J.3, Everett D.3, Tanton C.2, Clayton T.2, Ross D.2, Hayes R.2
1African Medical & Research Foundation, Mwanza, Tanzania, United Republic of, 2London School of Hygiene & Tropical Medicine, London, United Kingdom, 3National Institute of Medical Research, Mwanza, Tanzania, United Republic of

12:00
MOAC105
Abstract
Powerpoint (80 KB)		HIV-1 and STIs prevalence and risk factors among miners and female sex workers in the mining areas of Gejiu, Yunnan, China
Presented by Ding Guowei, China
Wang N.1, Zhang G.L.1, Pu Y.2, Xu J.J.1, Li B.S.2, Ding G.W.1, Ma Y.L.3, Wang H.B.1, Zheng X.W.1, Wu Z.L.4
1Chinese Center for Diseases Control and Prevention, Center for STD/AIDS Control and Prevention, Beijing, China, 2Gejiu City Center for Disease Control and Prevention, Gejiu, China, 3Yunnan Province Center for Disease Control and Prevention, Kunming, China, 4The Peking Union Medical College, Beijing, China


Audio files:
  1. audio file - high quality (mp3 format, 33.1 MB)
  2. audio file - low quality (mp3 format, 16.6 MB)

Rapporteur report

Track C: Biomedical Prevention report by Rebecca Guy

This session examined STI Treatment for HIV prevention.

 

Herpes simplex virus type 2 (HSV2) and HIV –HSV2 is an important co-factor of HIV transmission and acquisition; increasing susceptibility through HIV shedding. A meta-analysis of longitudinal studies conducted by Freeman et al has previously shown there is a three-fold increased risk of acquiring HIV with HSV-2 infection in both women and men.

 

Bautista presented results from a matched case-control study confirming the association between HSV-2 and incident HIV-1 infection in a US military population (AOR= 3.9 95% CI=2.8-5.6) and the population attributable risk of HIV due to HSV-2 was 23% (95% CI=18-28%). Bautista suggested (i) enhanced testing of HIV positive status individuals and individuals who report high risk sexual behaviour and (ii) treatment with valacyclovir as potential public health strategies for reducing HIV incidence. Valacyclovir and acyclovir are antiviral drugs that can suppress genital herpes with potential benefits in reducing HIV infection. Valacyclovir has a longer half life than acyclovir.  

 

Watson-Jones explored the utility of acyclovir 400mg b.d to reduce HIV incidence among women at high risk of infection in northern Tanzania. A randomised double-blind placebo controlled trial was conducted among initially HIV-seronegative, HSV-2 seropositive women in northern Tanzania working in bars, guesthouses and similar facilities. Among HIV negatives, 26% withdrew from taking tablets, most (79%) due to pregnancy. No drug-related adverse affects were reported.  There was no impact of acyclovir on HIV incidence, however among periods with high (>=90%) adherence, there was some evidence of an impact (RR=0.58, 95% CI 0.25-1.38) although this is not statistically significant. Watson-Jones suggested further studies involving acyclovir may require higher adherence levels, but this may be challenging. 

 

Trichomonas vaginalis and HSV2 – Madhivanan focused on possible STI co-factors of HSV2 which could be considered in treatment prevention strategies and presented base-line data from a prospective cohort study of about 900 sexually active women in Mysore, India. Nine percent of individuals were infected with Trichomonas vaginalis and 13% with HSV-2. Trichomonas vaginalis was independently associated with prevalent HSV-2. These findings suggest diagnosis and treatment of lower genital tract infections could be a cost effective strategy to reduce HIV incidence among women in India. Studies presented by Madhivanan and Bautista would benefit from cohort studies to confirm the temporarily of the association.




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