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      Trends of HIV/Syphilis/HSV-2 seropositive rate and factors associated with HSV-2 infection in men who have sex with men in Shenzhen, China: A retrospective study

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          Abstract

          Objectives

          To analyze the trends of HIV/syphilis/HSV-2 seropositive rate and explore the related factors with HSV-2 infection to provide the basis for adjusting STD intervention strategies and formulating prevention and control measures among MSM in Shenzhen.

          Methods

          Time-location sampling was conducted among MSM in Shenzhen in 2012, 2014, 2016, and 2018. Data on demographics, sexual behaviors and the laboratory test results of HIV, syphilis, HSV-2 were collected. The χ 2 trend test was used to analyze the trends of HIV/syphilis/HSV-2 seropositive rate. The binary logistic regression model was used to explore the factors associated with HSV-2 infection.

          Results

          The seropositive rate of HIV fell significantly from 15.9% in 2012 to 8.7% in 2018 ( P trend = 0.003), syphilis seropositive rate was significantly decreased from 20.4% in 2012 to 14.8% in 2018 ( P trend = 0.025), HSV-2 seropositive rate had no significant change (16.7% in 2012 to 14.0% in 2018; P trend = 0.617). In principal component logistic regression analysis showed that FAC1_1 (X 1 = Ever had sex with female, X 2 = Gender of first sexual partner, X 3 = Marital status, X 4 = Age group), FAC2_1 (X 5 = Education, X 6 = Monthly income (RMB), X 7 = Frequency of condom use in anal sex with men in the past 6 months), and FAC4_1 (X 9 = History of STDs) were significantly associated with HSV-2 infection.

          Conclusions

          The seropositive rates of HIV and syphilis have dropped significantly but are still high. HSV-2 seropositive rate had no significant change and maintained a high level. It is necessary to continue strengthening HIV and syphilis interventions among MSM in Shenzhen. HSV-2 detection and intervention are urgently required for MSM, which might be another effective biological strategy further to control the HIV epidemic among MSM in Shenzhen.

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          Most cited references33

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          Age-specific prevalence of infection with herpes simplex virus types 2 and 1: a global review.

          Information on age- and sex-specific prevalence of herpes simplex virus (HSV) types 2 and 1 infections is essential to optimize genital herpes control strategies, which increase in importance because accumulating data indicate that HSV-2 infection may increase acquisition and transmission of human immunodeficiency virus. This review summarizes data from peer-reviewed publications of type-specific HSV seroepidemiologic surveys. HSV-2 prevalence is, in general, highest in Africa and the Americas, lower in western and southern Europe than in northern Europe and North America, and lowest in Asia. HSV-2 and -1 prevalence, overall and by age, varies markedly by country, region within country, and population subgroup. Age-specific HSV-2 prevalence is usually higher in women than men and in populations with higher risk sexual behavior. HSV-2 prevalence has increased in the United States but national data from other countries are unavailable. HSV-1 infection is acquired during childhood and adolescence and is markedly more widespread than HSV-2 infection. Further studies are needed in many geographic areas.
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            Genital herpes.

            Genital herpes is the main cause of genital ulcers worldwide; the prevalence of herpes simplex virus (HSV) type 2 infections in the general population ranges from 10% to 60%. Most genital herpes is caused by HSV-2, although HSV-1 accounts for about half of new cases in developed countries. The risk of HIV acquisition is three times higher in people with HSV-2. Neonatal herpes is an uncommon but serious complication of genital herpes. Most genital HSV-2 infections are unrecognised and undiagnosed; infected individuals, even with mild symptoms, shed HSV, and can infect sexual partners. Since clinical diagnosis is neither sensitive nor specific, virological and type-specific serological tests should be used routinely. Oral antiviral drugs for HSV infections are safe and effective and can be used both to treat episodes and to prevent recurrences. Antiviral treatment of the infected partners and condom use reduce the risk of sexual transmission of HSV-2.
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              Syphilis and HIV: a dangerous combination.

              HIV and syphilis affect similar patient groups and co-infection is common. All patients presenting with syphilis should be offered HIV testing and all HIV-positive patients should be regularly screened for syphilis. Syphilis agent may enhance the transmission of the other, probably through increased incidence of genital ulcers. Detection and treatment of syphilis can, therefore, help to reduce HIV transmission. Syphilis may present with non-typical features in the HIV-positive patient: there is a higher rate of symptomless primary syphilis and proportionately more HIV-positive patients present with secondary disease. Secondary infection may be more aggressive and there is an increased rate of early neurological and ophthalmic involvement. Diagnosis is generally made with serology but the clinician should be aware of the potential for false-negative serology in both primary and, less commonly, in secondary syphilis. All HIV-positive patients should be treated with a penicillin-based regimen that is adequate for the treatment of neurosyphilis. Relapse of infection is more likely in the HIV-positive patient and careful follow-up is required.
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                Author and article information

                Contributors
                Role: Data curationRole: Formal analysisRole: MethodologyRole: SoftwareRole: Writing – original draftRole: Writing – review & editing
                Role: MethodologyRole: Writing – review & editing
                Role: Data curationRole: InvestigationRole: Software
                Role: Data curationRole: MethodologyRole: Software
                Role: Formal analysisRole: Funding acquisitionRole: Methodology
                Role: Software
                Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                20 May 2021
                2021
                : 16
                : 5
                : e0251929
                Affiliations
                [1 ] School of Public Health, University of South China, Hengyang, Hunan, China
                [2 ] Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China
                [3 ] Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
                China Medical University, CHINA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0002-3266-0594
                Article
                PONE-D-21-03597
                10.1371/journal.pone.0251929
                8136746
                34015057
                c2028512-918d-4717-ab8c-eb34193dfb5c
                © 2021 Mao et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 2 February 2021
                : 5 May 2021
                Page count
                Figures: 3, Tables: 3, Pages: 16
                Funding
                Funded by: National Natural Science Foundation of China
                Award ID: 81270043
                Award Recipient :
                Funded by: National Natural Science Foundation of China
                Award ID: 81573211
                Award Recipient :
                Funded by: National Key S&T Special Projects on Major Infectious Diseases
                Award ID: 2018ZX10721102
                Award Recipient :
                Funded by: Guangdong Basic and Applied Basic Research Foundation
                Award ID: 2019B1515120003
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100012151, Sanming Project of Medicine in Shenzhen;
                Award ID: SZSM201811071
                Award Recipient :
                Funded by: Shenzhen Key Medical Discipline Construction Fund
                Award ID: SZXK064
                Award Recipient :
                Funded by: Medical Scientific Research Foundation of Guangdong
                Award ID: A2019474
                Award Recipient :
                Funded by: Shenzhen Health System Research Project
                Award ID: SZGW201810003
                Award Recipient :
                This work was funded by the National Natural Science Foundation of China (81573211 and 81270043), the National Key S&T Special Projects on Major Infectious Diseases (2018ZX10721102), Guangdong Basic and Applied Basic Research Foundation (2019B1515120003), San-Ming Project of Medicine in Shenzhen (SZSM201811071) and Shenzhen Key Medical Discipline Construction Fund (SZXK064), Medical Scientific Research Foundation of Guangdong (A2019474), Shenzhen Health System Research Project (SZGW201810003). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. manuscript.
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