Sex Transm Infect

Objective:There is an urgent need to understand high HIV-infection rates among young women in sub-Saharan Africa. While age-disparate partnerships have been characterised with higher risk sexual behaviours, the mechanisms through which these partnerships may increase HIV-risk are not fully understood. This study assessed the association between age-disparate partnerships and herpes simplex virus type-2 (HSV-2) infection, a factor known to increase HIV-infection risk.Methods:Cross-sectional face-to-face questionnaire data, and laboratory HSV-2 and HIV antibody data were collected among a representative sample in the 2014/15 household survey of the HIV Incidence Provincial Surveillance System (HIPSS) in KwaZulu-Natal, South Africa. Among 15\u201324 year-old women who reported having ever had sex (N=1550), the association between age-disparate partnerships (ie, male partner 655 years older) and HSV-2 antibody status was assessed using multivariable Poisson regression models with robust variance. Analyses were repeated among HIV-negative women.Results:HSV-2 prevalence was 55% among 15\u201324 year-old women. Women who reported an age-disparate partnership with their most recent partner were more likely to test HSV-2 positive compared to women with age-similar partners (64% vs 51%; adjusted prevalence ratio (aPR):1.19 (95% CI: 1.07\u20131.32, p