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Strong Country Level Correlation between Syphilis and HSV-2 Prevalence
Background: Syphilis is curable but Herpes Simplex Virus-2 (HSV-2) is not. As a result, the prevalence of syphilis but not HSV-2 may be influenced by the efficacy of national STI screening and treatment capacity. If the prevalence of syphilis and HSV-2 is found to be correlated, then this makes it more likely that something other than differential STI treatment is responsible for variations in the prevalence of both HSV-2 and syphilis. Methods: Simple linear regression was used to evaluate the relationship between national antenatal syphilis prevalence and HSV-2 prevalence in women in two time periods: 1990–1999 and 2008. Adjustments were performed for the laboratory syphilis testing algorithm used and the prevalence of circumcision. Results: The prevalence of syphilis was positively correlated with that of HSV-2 for both time periods (adjusted correlations, 20–24-year-olds: 1990–99: 𝑅2 = 0.54, 𝑃 < 0.001; 2008: 𝑅2 = 0.41, 𝑃 < 0.001 and 40–44-year-olds: 1990–99: 𝑅2 = 0.42, 𝑃 < 0.001; 2008: 𝑅2 = 0.49, 𝑃 < 0.001). Conclusion: The prevalence of syphilis and HSV-2 is positively correlated.This could be due to a common set of risk factors underpinning both STIs.
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