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. 2014 Dec;90(8):620-6.
doi: 10.1136/sextrans-2014-051548. Epub 2014 May 29.

Prevalence of HIV, HSV-2 and pregnancy among high school students in rural KwaZulu-Natal, South Africa: a bio-behavioural cross-sectional survey

Quarraisha Abdool Karim  1 , Ayesha B M Kharsany  2 , Kerry Leask  2 , Fanelisibonge Ntombela  2 , Hilton Humphries  2 , Janet A Frohlich  2 , Natasha Samsunder  2 , Anneke Grobler  2 , Rachael Dellar  2 , Salim S Abdool Karim  1
Affiliations

Prevalence of HIV, HSV-2 and pregnancy among high school students in rural KwaZulu-Natal, South Africa: a bio-behavioural cross-sectional survey

Quarraisha Abdool Karim et al. Sex Transm Infect. 2014 Dec.

Abstract

Objective: Adolescents in southern African high schools are a key population for HIV prevention interventions. We report on the prevalence of HIV, HSV-2 and pregnancy as indicators of high-risk sexual behaviour among high school students in rural KwaZulu-Natal.

Design: Bio-behavioural cross-sectional survey.

Methods: Students completed a self-administered structured, standardised demographic and sexual behavioural questionnaire. Dried blood spot specimens were collected for HIV and HSV-2 testing. Urine specimens were used for pregnancy testing in female students.

Results: A total of 2675 (1423 females, 1252 males) consenting students were enrolled from 14 high schools between September and November 2010. The median age of students was 16 years (IQR 15-18). HIV prevalence was 1.4% (95% CI 0.9 to 1.9) in males and 6.4% (95% CI 4.6 to 8.3) in females (p<0.001). HSV-2 prevalence was 2.6% (95% CI 1.6 to 3.7) in males and 10.7% (95% CI 8.8 to 12.6) in females (p<0.001). Pregnancy prevalence was 3.6% (95% CI 2.6 to 4.5). Risk factors for prevalent HIV infection in female students included being over 18 years of age (adjusted OR (aOR)=2.67, 95% CI 1.67 to 4.27; p<0.001), prevalent HSV-2 infection (aOR=4.35, 95% CI 2.61 to 7.24; p<0.001), previous pregnancy (aOR=1.66, 95% CI 1.10 to 2.51; p=0.016) and experience of two or more deaths in the household in the previous year (aOR=1.97, 95% CI 1.13 to 3.44; p=0.016).

Conclusions: The high prevalence of HIV, HSV-2 and pregnancy underscore the need for school-based sexual and reproductive health services, and provide further impetus for the inclusion of adolescents in behavioural and biomedical trials with HIV incidence endpoints.

Keywords: Adolescent; Africa; HIV; HSV; Pregnancy.

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Conflict of interest statement

Competing Interests

The authors declare no conflicts of interest.

References

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