A Serosurvey of Haemophilus ducreyi, Syphilis, and Herpes Simplex Virus Type 2 and Their Association With Human Immunodeficiency Virus Among Female Sex Workers in Lagos, Nigeria

Abstract

To determine the prevalence rates of serological reactivity ofHaemophilus (H.) ducreyi, Treponema pallidum,and herpes simplex virus type 2 (HSV-2) antibodies among female sex workers (FSWs) and their association with human immunodeficiency virus (HIV) antibody status. Cross-sectional, standard serological assays were used for syphilis, HSV-2 and HIV; a modified enzymelinked immunosorbent assay (ELISA) was used to detect specific anti-H. ducreyiimmunoglobulin (Ig) G and IgA antibodies. Seroprevalence rates were 86% for anti-H. ducreyiIgG and 69% for anti-H. ducreyiIgA; 4% for rapid plasma reagin (RPR) andTreponema palladiumhemagglutination assay (TPHA) confirmed syphilis; 59% for HSV-2; 12% for HIV-1 and 2% for HIV-2. Lower-class FSWs were significantly more likely than upper-class FSWs to beH. ducreyiseropositive (IgG: OR = 42.7; IgA: OR = 7.6) and have current or past syphilis infection (RPR: OR = 3.5; RPR and TPHA: OR = 4.5). The presence of syphilis increased significantly with older age (P-trend H. ducreyiseropositivity was significantly more likely in FSWs with HSV-2 (OR = 2.4) and syphilis (OR = 5.6). Chancroid and HSV-2 antibodies were also more common in HIV-infected FSWs. The prevalence ofH. ducreyiantibodies is the highest rate that has been reported. Our findings underscore the importance of an effective program to control GUDs as part of the strategy to prevent the potentially explosive spread of HIV in Nigeria.