Dispelling the Myth: What Parents Really Think about Sex Education in Schools

Background: School-based sex education is effective in reducing risky sexual behavior among adolescents that may lead to unintended pregnancies and sexually transmitted infections. However, most sex education policies in the US do not support evidence-based programs. Understanding parental attitudes around sex education is crucial to overcoming perceived barriers to implementing school-based sex education. Little research has been published on the opinions of parents in Texas, which accounts for 12% of the nation���s teen births. Purpose: The purpose of this study was to examine whether Texas parents favor teaching sex education in schools, in what grades they think sex education should be taught, what content they think should be taught, and who they think should make decisions regarding sex education. Methods: We commissioned a telephone survey of parents of children 18 years or younger in Harris County, Texas. Survey questions assessed demographic characteristics and opinions about sex education. We used chi-square tests to examine differences across sociodemographic characteristics. Results: 1,201 parents completed the survey. The majority of parents (80%) responded that sex education should begin in middle school or earlier, and two-thirds said that it should include information about condoms and contraception. Hispanic parents showed the highest support for teaching sex education and providing medically accurate information on condoms and contraception in middle school or earlier. Conclusion: Parents in Harris County overwhelmingly support sex education that includes medically accurate information about condoms and contraception beginning before high school. These data provide evidence to change sex education policies to better reflect parental opinions.

Toxic Stress and Child Hunger Over the Life Course: Three Case Studies

The causes and contexts of food insecurity among children in the U.S. are poorly understood because the prevalence of food insecurity at the child level is low compared to the prevalence of household food insecurity. In addition, caregivers may be reluctant to admit their children may not be getting enough food due to shame or fear they might lose custody of their children. Based on our ongoing qualitative research with mothers of young children, we suggest that food security among children is related to adverse childhood experiences of caregivers. This translates into poor mental and physical health in adolescence and adulthood, which can lead to inability to secure and maintain meaningful employment that pays a living wage. In this paper we propose that researchers shift the framework for understanding food insecurity in the United States to adopt a life course approach. This demands we pay greater attention to the lifelong consequences of exposure to trauma or toxic stress���exposure to violence, rape, abuse and neglect, and housing, food, and other forms of deprivation���during childhood. We then describe three case studies of women from our ongoing study to describe a variety of toxic stress exposures and how they have an impact on a woman���s earning potential, her mental health, and attitudes toward raising children. Each woman describes her exposure to violence and deprivation as a child and adolescent, describes experiences with child hunger, and explains how her experiences have shaped her ability to nourish her children. We describe ways in which we can shift the nature of research investigations on food insecurity, and provide recommendations for policy-oriented solutions regarding income support programs, early intervention programs, child and adult mental health services, and violence prevention programs.

The influence of the valence of events on the intention superiority effect over the life-course

According to the intention superiority effect, people remember more future intentions than past events. Moreover, several studies have shown a facilitation of retrieving positive compared to negative or neutral events. The aim of the present study was to investigate the influence of age on the intention superiority effect for positive, negative and neutral events. We asked a group of young and a group of older adults to report their future intentions and their memories of past events from a specific time-window (i.e., day, week or year). Additionally, we prompted them to rate each intention/memory as positive, negative or neutral. The results showed more positive than negative or neutral future and past events in both age-groups and more negative events of young adults compared with reported negative events of older adults. Critically, there was an intention superiority effect for positive events in both age-groups, but only in the ���year��� time-window. These results suggest that the retrieval of positive future events is facilitated, at least for a large time-perspective, and independent of age-effects.

Home-based versus clinic-based specimen collection in the management of Chlamydia trachomatis and Neisseria gonorrhoeae infections

BACKGROUND Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are the most frequent causes of bacterial sexually transmitted infections (STIs). Management strategies that reduce losses in the clinical pathway from infection to cure might improve STI control and reduce complications resulting from lack of, or inadequate, treatment. OBJECTIVES To assess the effectiveness and safety of home-based specimen collection as part of the management strategy for Chlamydia trachomatis and Neisseria gonorrhoeae infections compared with clinic-based specimen collection in sexually-active people. SEARCH METHODS We searched the Cochrane Sexually Transmitted Infections Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and LILACS on 27 May 2015, together with the World Health Organization International Clinical Trials Registry (ICTRP) and ClinicalTrials.gov. We also handsearched conference proceedings, contacted trial authors and reviewed the reference lists of retrieved studies. SELECTION CRITERIA Randomized controlled trials (RCTs) of home-based compared with clinic-based specimen collection in the management of C. trachomatis and N. gonorrhoeae infections. DATA COLLECTION AND ANALYSIS Three review authors independently assessed trials for inclusion, extracted data and assessed risk of bias. We contacted study authors for additional information. We resolved any disagreements through consensus. We used standard methodological procedures recommended by Cochrane. The primary outcome was index case management, defined as the number of participants tested, diagnosed and treated, if test positive. MAIN RESULTS Ten trials involving 10,479 participants were included. There was inconclusive evidence of an effect on the proportion of participants with index case management (defined as individuals tested, diagnosed and treated for CT or NG, or both) in the group with home-based (45/778, 5.8%) compared with clinic-based (51/788, 6.5%) specimen collection (risk ratio (RR) 0.88, 95% confidence interval (CI) 0.60 to 1.29; 3 trials, I�� = 0%, 1566 participants, moderate quality). Harms of home-based specimen collection were not evaluated in any trial. All 10 trials compared the proportions of individuals tested. The results for the proportion of participants completing testing had high heterogeneity (I�� = 100%) and were not pooled. We could not combine data from individual studies looking at the number of participants tested because the proportions varied widely across the studies, ranging from 30% to 96% in home group and 6% to 97% in clinic group (low-quality evidence). The number of participants with positive test was lower in the home-based specimen collection group (240/2074, 11.6%) compared with the clinic-based group (179/967, 18.5%) (RR 0.72, 95% CI 0.61 to 0.86; 9 trials, I�� = 0%, 3041 participants, moderate quality). AUTHORS' CONCLUSIONS Home-based specimen collection could result in similar levels of index case management for CT or NG infection when compared with clinic-based specimen collection. Increases in the proportion of individuals tested as a result of home-based, compared with clinic-based, specimen collection are offset by a lower proportion of positive results. The harms of home-based specimen collection compared with clinic-based specimen collection have not been evaluated. Future RCTs to assess the effectiveness of home-based specimen collection should be designed to measure biological outcomes of STI case management, such as proportion of participants with negative tests for the relevant STI at follow-up.

Genetic Resistance Determinants, In Vitro Time-Kill Curve Analysis and Pharmacodynamic Functions for the Novel Topoisomerase II Inhibitor ETX0914 (AZD0914) in Neisseria gonorrhoeae.

Resistance in Neisseria gonorrhoeae to all available therapeutic antimicrobials has emerged and new efficacious drugs for treatment of gonorrhea are essential. The topoisomerase II inhibitor ETX0914 (also known as AZD0914) is a new spiropyrimidinetrione antimicrobial that has different mechanisms of action from all previous and current gonorrhea treatment options. In this study, the N. gonorrhoeae resistance determinants for ETX0914 were further described and the effects of ETX0914 on the growth of N. gonorrhoeae (ETX0914 wild type, single step selected resistant mutants, and e���ux pump mutants) were examined in a novel in vitro time-kill curve analysis to estimate pharmacodynamic parameters of the new antimicrobial. For comparison, ciprofloxacin, azithromycin, ceftriaxone, and tetracycline were also examined (separately and in combination with ETX0914). ETX0914 was rapidly bactericidal for all wild type strains and had similar pharmacodynamic properties to ciprofloxacin. All selected resistant mutants contained mutations in amino acid codons D429 or K450 of GyrB and inactivation of the MtrCDE e���ux pump fully restored the susceptibility to ETX0914. ETX0914 alone and in combination with azithromycin and ceftriaxone was highly effective against N. gonorrhoeae and synergistic interaction with ciprofloxacin, particularly for ETX0914-resistant mutants, was found. ETX0914, monotherapy or in combination with azithromycin (to cover additional sexually transmitted infections), should be considered for phase III clinical trials and future gonorrhea treatment.

Sexual health in hematopoietic stem cell transplant recipients

Hematopoietic stem cell transplantation (HSCT) plays a central role in patients with malignant and, increasingly, nonmalignant conditions. As the number of transplants increases and the survival rate improves, long-term complications are important to recognize and treat to maintain quality of life. Sexual dysfunction is a commonly described but relatively often underestimated complication after HSCT. Conditioning regimens, generalized or genital graft-versus-host disease, medications, and cardiovascular complications as well as psychosocial problems are known to contribute significantly to physical and psychological sexual dysfunction. Moreover, it is often a difficult topic for patients, their significant others, and health care providers to discuss. Early recognition and management of sexual dysfunction after HSCT can lead to improved quality of life and outcomes for patients and their partners. This review focuses on the risk factors for and treatment of sexual dysfunction after transplantation and provides guidance concerning how to approach and manage a patient with sexual dysfunction after HSCT.

The determinants of sexually transmitted infection screening uptake among African American young adults: A systematic review

Objective. To conduct a systematic review of literature to determine the factors associated with STI including HIV screening uptake among African American young adults in the United States. ^ Methods. The electronic databases OVID Medline and OVID PsycINFO were systematically searched to identify potentially relevant articles. Ninety-six articles were initially identified, five of which were included in the final review. ^ Results. The results of this review were inconclusive. There was no definitive evidence to suggest which determinants were predictive of screening uptake. ^ Conclusions. There is a limited body of literature examining the demographic and behavioral risk factors associated with uptake or non-uptake of STI including HIV screening among African American young adult populations. This finding points to the need for more quality research to be conducted in this area. ^

Barriers to adolescent and young men's access of reproductive health care

Purpose. The purpose of this study was to identify the health needs and barriers that young men face in accessing health care and family planning services and to identify what health centers can do to attract young men to the clinic. A focus group format was used to elicit ideas from participants. ^ Methods. Forty-eight young men participated in nine focus groups. The young men were asked about the health issues they have, the barriers they face in accessing reproductive health care, and what clinics can do to attract young men to the clinic. Thematic analysis principles were used to identify the main themes that emerged in the focus groups. ^ Results. Sexually transmitted infections (STIs), mental health problems, and drug use were the major health issues that were mentioned in the majority of the focus groups. The main barriers discussed in the focus groups were attitudinal factors such as young men thinking it is unmanly to seek help, emotional factors such as young men not seeking help because of their ego or pride, and institutional factors such as the location of the clinic. The main suggestions for improvements in the health clinic included decreasing waiting times, emphasizing the fact that the clinics are free for males, having more female nurses, and encouraging clinic staff to treat the young men with respect. Young men suggested advertising and promoting the clinic in schools, in the community, and through the media. Focus group participants also provided their input about the design and format of the clinic flyer. ^ Conclusions. Many studies focus on the reproductive health care needs of adolescent and young females. This study has helped to show that young men also have health care needs and face barriers to accessing reproductive health care services.^

African American and Hispanic adolescent STI and pregnancy prevention: Whose responsibility is it, anyway?

This dissertation utilized quantitative and qualitative methods to examine the role of responsibility in the prevention of sexually transmitted infections (STIs) and pregnancy through condom use and other sexual behaviors among young adolescents. Data were analyzed across race and gender and three papers were developed. The quantitative portion used logistic regression to assess associations between personal responsibility, as well as other know correlates, and reported condom use and condom use intentions as a means of STI and pregnancy prevention among 445 inner-city, high school adolescents. Responsibility to prevent pregnancy by providing the condom was associated with condom use at last sex and consistent condom use. Responsibility to prevent acquiring a STI by using a condom was significantly associated with consistent condom use. No significant associations were found between responsibility and condom use intentions. ^ The qualitative section of the dissertation project involved conducting 28 in-depth interviews among 9th and 10th grade, African American and Hispanic students who attended a large urban school district in South Central Texas. Perceptions of responsibility for preventing STIs and unintended pregnancy, as well as for condom use, were explored. Male and female adolescents expressed joint responsibility to prevent a STI or pregnancy. Perceptions of responsibility for providing and using the condoms were mixed. Despite the indication of both partners, mostly all participants implied that females, more so than the males, had the final responsibility to prevent contracting a STI, a pregnancy, to provide a condom, and to make sure a condom was used. Participants expressed the role of parents' involvement for preventing these outcomes as well as the need for more sexual health education and access to preventative methods. ^ The last section of this dissertation involved qualitative inquiry to ascertain perceptions of reasons why adolescents engage in anal and oral (non-coital) sex. Pleasure-seeking and giving as well social influence and pressure were described as the main reasons why teenagers have non-coital sex. Other reasons included conveniences of participating in these behaviors such as ease of performing oral sex and anal sex as a convenient alternative to vaginal sex. Sexual inexperience was an indicator for why anal sex occurs. Many of the reasons involved misperceptions and adolescents who practice these sexual behaviors place themselves at-risk for contracting a STI. ^ This dissertation increased the current knowledge base about adolescent sexual responsibility and non-coital behaviors. Future studies should explore perceptions of responsibility and actual sexual activity practices among adolescents to reduce the burden of STIs and pregnancy as well as help public health professionals develop programs for adolescent populations, schools, and communities where these issues persist.^

Risk and resiliency: The untold story of youth in military families

Background: Risky sexual behaviors have been shown to increase the risk of unintended pregnancy and sexually transmitted infections (STIs) among youth. Youth in military families may be especially at risk for engaging in risky sexual behaviors because they are exposed to factors that are unique to the military culture, such as multiple relocations and parental deployment. However, data on sexual behaviors among military-dependent youth are limited and few studies have examined how these factors influence the sexual behaviors among youth. Purpose: The purpose of this dissertation was to estimate the prevalence of risky sexual behaviors among military-dependent youth and to describe how military factors may influence their sexual behaviors. Methods: Youth, aged 15���19 years, who attended a military health facility in the southern United States between June 2011 and September 2011 were recruited to complete a short, paper-based survey (N= 208, males and females) and to participate in an in-depth interview (N = 25, females). For quantitative data, prevalence estimates were computed and chi-square analyses were conducted. Logistic regression analyses were also conducted, adjusting for age, gender, and parents' duty status. For qualitative data, thematic coding of transcribed interviews was performed. Common and unique themes were examined across participants' experiences. Results: Over half of the youth was sexually experienced (53.7%). Parental deployment and number of relocations were significantly associated with having had sex in the past 3 months; however no significant associations were found between these military factors and other sexual behaviors. Although some youth felt that being a military-dependent had negatively impacted their sexual decisions, most believed the military experience had little influence on their sexual decisions. Most youth in military families also perceived having higher parental expectations to avoid risky behaviors, in general, than youth in civilian families. Conclusions: The majority of military-dependent youth are sexually experienced; however, individual and parental factors may have a greater role in sexual initiation among youth than military stressors do. The findings highlight the need for implementation of evidence-based strategies to prevent teen pregnancy and STIs at military installations. Future studies with larger sample sizes are needed to further explore how youth may cope with these military factors and the impact of parental factors on the sexual behaviors of youth.^

Advance provision of emergency contraception for pregnancy prevention (Review)

Background Emergency contraception can prevent pregnancy when taken after unprotected intercourse.Obtaining emergency contraception within the recommended time frame is difficult for many women. Advance provision could circumvent some obstacles to timely use. Objectives To summarize randomized controlled trials evaluating advance provision of emergency contraception to explore effects on pregnancy rates, sexually transmitted infections, and sexual and contraceptive behaviors. Search strategy In November 2009, we searched CENTRAL, EMBASE, POPLINE,MEDLINE via PubMed, and a specialized emergency contraception article database. We also searched reference lists and contacted experts to identify additional published or unpublished trials. Selection criteria We included randomized controlled trials comparing advance provision and standard access (i.e., counseling whichmay ormay not have included information about emergency contraception, or provision of emergency contraception on request at a clinic or pharmacy). Data collection and analysis Two reviewers independently abstracted data and assessed study quality. We entered and analyzed data using RevMan 5.0.23. Main results Eleven randomized controlled trials met our criteria for inclusion, representing 7695 patients in the United States, China, India and Sweden. Advance provision did not decrease pregnancy rates (odds ratio (OR) 0.98, 95% confidence interval (CI) 0.76 to 1.25 in studies for which we included twelve-month follow-up data; OR 0.48, 95% CI 0.18 to 1.29 in a study with seven-month follow-up data; OR 0.92, 95% CI 0.70 to 1.20 in studies for which we included six-month follow-up data; OR 0.49, 95% CI 0.09 to 2.74 in a study with three-month follow-up data), despite reported increased use (single use: OR 2.47, 95% CI 1.80 to 3.40; multiple use: OR 4.13, 95% CI 1.77 to 9.63) and faster use (weighted mean difference (WMD) -12.98 hours, 95% CI -16.66 to -9.31 hours). Advance provision did not lead to increased rates of sexually transmitted infections (OR 1.01, 95% CI 0.75 to 1.37), increased frequency of unprotected intercourse, or changes in contraceptive methods.Women who received emergency contraception in advance were equally likely to use condoms as other women. Authors��� conclusions Advance provision of emergency contraception did not reduce pregnancy rates when compared to conventional provision. Results from primary analyses suggest that advance provision does not negatively impact sexual and reproductive health behaviors and outcomes. Women should have easy access to emergency contraception, because it can decrease the chance of pregnancy.However, the interventions tested thus far have not reduced overall pregnancy rates in the populations studied.

Sexualidade nos adolescentes : interven����o formativa

Enquadramento ��� Os adolescentes com acesso a conhecimentos, informa����o e motiva����o, para adotarem comportamentos sexuais seguros, ser��o capazes de alterar as suas atitudes e os seus comportamentos. Objetivos ��� Caraterizar os adolescentes relativamente ��s vari��veis de contexto sexual; identificar os conhecimentos dos adolescentes sobre IST e planeamento familiar; identificar as atitudes dos adolescentes face �� sexualidade, p��lula e preservativos; identificar a motiva����o dos adolescentes para terem ou n��o rela����es sexuais; determinar a efic��cia de uma interven����o formativa no ��mbito da sexualidade nos conhecimentos sobre IST, Planeamento Familiar, bem como nas suas atitudes face �� sexualidade. M��todos - Investiga����o experimental de campo. O instrumento de recolha de dados �� um question��rio, elaborado pela equipa de investigadores do Projeto Monitoriza����o de Indicadores de Sa��de Infanto-Juvenil (MISIJ) no dom��nio tem��tico da ���Sexualidade Adolescente���. Este permite caracterizar sociodemograficamente e sexualmente os adolescentes, inclui ainda a Escala de atitudes face �� sexualidade em adolescentes (AFSA) (Nelas et al., 2010), Escala de conhecimentos sobre infe����es de transmiss��o sexual (Nelas et al., 2010), Escala de atitudes face ao preservativo (Ramos et al., 2009), Escala de atitudes face �� p��lula (Ramos et al., 2009), Escala de conhecimentos sobre planeamento familiar (Nelas et al., 2010), Escala de motiva����o para fazer e para n��o fazer sexo (Alferes, 1997). Resultados - A amostra �� constitu��da por 56 estudantes do 9�� ano de escolaridade (28 do grupo de controlo e 28 do grupo experimental). A maioria dos adolescentes do grupo de controlo �� do sexo feminino (71,4%), contrariamente ao grupo de controlo onde 64,3% �� do sexo masculino. As raparigas do grupo de controlo revelaram mais conhecimentos sobre infe����es transmiss��veis sexualmente, em ambos os momentos da avalia����o, os adolescentes do sexo masculino, em ambos os momentos, revelam mais conhecimentos sobre o planeamento familiar, comparativamente ��s adolescentes do g��nero feminino. Aos ��ndices positivos antes da interven����o formativa corresponderam melhores ��ndices ap��s a interven����o formativa. Conclus��o - Os profissionais de sa��de devem, atrav��s da educa����o para a sa��de, promover atitudes que promovam a sa��de sexual e reprodutiva e promover o desenvolvimento de compet��ncias indispens��veis para ado����o de comportamentos saud��veis. Palavras-chave - Adolescentes; Sexualidade; Educa����o sexual; Interven����o formativa.

Is socioeconomic position early in life associated with physical activity during adulthood following the accumulation of risk model with additive effects?

L'activit�� physique am��liore la sant��, mais seulement 4.8% des Canadiens atteignent le niveau recommand��. La position socio-��conomique est un des d��terminants de l'activit�� physique les plus importants. Elle est associ��e �� l���activit�� physique de mani��re transversale �� l���adolescence et �� l�����ge adulte. Cette th��se a tent�� de d��terminer s'il y a une association �� long terme entre la position socio-��conomique au d��but du parcours de vie et l���activit�� physique �� l�����ge adulte. S'il y en avait une, un deuxi��me objectif ��tait de d��terminer quel mod��le th��orique en ��pid��miologie des parcours de vie d��crivait le mieux sa forme. Cette th��se comprend trois articles: une recension syst��matique et deux recherches originales. Dans la recension syst��matique, des recherches ont ��t�� faites dans Medline et EMBASE pour trouver les ��tudes ayant mesur�� la position socio-��conomique avant l'��ge de 18 ans et l'activit�� physique �� ���18 ans. Dans les deux recherches originales, la mod��lisation par ��quations structurelles a ��t�� utilis��e pour comparer trois mod��les alternatifs en ��pid��miologie des parcours de vie: le mod��le d���accumulation de risque avec effets additifs, le mod��le d���accumulation de risque avec effet d��clench�� et le mod��le de p��riode critique. Ces mod��les ont ��t�� compar��s dans deux cohortes prospectives repr��sentatives �� l'��chelle nationale: la 1970 British birth cohort (n=16,571; premi��re recherche) et l���Enqu��te longitudinale nationale sur les enfants et les jeunes (n=16,903; deuxi��me recherche). Dans la recension syst��matique, 10 619 articles ont ��t�� pass��s en revue par deux chercheurs ind��pendants et 42 ont ��t�� retenus. Pour le r��sultat ��activit�� physique�� (tous types et mesures confondus), une association significative avec la position socio-��conomique durant l���enfance fut trouv��e dans 26/42 ��tudes (61,9%). Quand seulement l���activit�� physique durant les loisirs a ��t�� consid��r��e, une association significative fut trouv��e dans 21/31 ��tudes (67,7%). Dans un sous-��chantillon de 21 ��tudes ayant une m��thodologie plus forte, les proportions d�����tudes ayant trouv�� une association furent plus hautes : 15/21 (71,4%) pour tous les types et toutes les mesures d���activit�� physique et 12/15 (80%) pour l���activit�� physique de loisir seulement. Dans notre premi��re recherche originale sur les donn��es de la British birth cohort, pour la classe sociale, nous avons trouv�� que le mod��le d���accumulation de risque avec effets additifs s���est ajust�� le mieux chez les hommes et les femmes pour l���activit�� physique de loisir, au travail et durant les transports. Dans notre deuxi��me recherche originale sur les donn��es canadiennes sur l'activit�� physique de loisir, nous avons trouv�� que chez les hommes, le mod��le de p��riode critique s���est ajust�� le mieux aux donn��es pour le niveau d�����ducation et le revenu, alors que chez les femmes, le mod��le d���accumulation de risque avec effets additifs s���est ajust�� le mieux pour le revenu, tandis que le niveau d�����ducation ne s���est ajust�� �� aucun des mod��les test��s. En conclusion, notre recension syst��matique indique que la position socio-��conomique au d��but du parcours de vie est associ��e �� la pratique d'activit�� physique �� l'��ge adulte. Les r��sultats de nos deux recherches originales sugg��rent un patron d���associations le mieux repr��sent�� par le mod��le d���accumulation de risque avec effets additifs.

High prevalence of herpes simplex virus (HSV)- type 2 co-infection among HIV-positive women in Ukraine, but no increased HIV mother-to-child transmission risk.

BACKGROUND Over 3500 HIV-positive women give birth annually in Ukraine, a setting with high prevalence of sexually transmitted infections. Herpes simplex virus Type 2 (HSV-2) co-infection may increase HIV mother-to-child transmission (MTCT) risk. We explored factors associated with HSV-2 seropositivity among HIV-positive women in Ukraine, and its impact on HIV MTCT. METHODS Data on 1513 HIV-positive women enrolled in the Ukraine European Collaborative Study from 2007 to 2012 were analysed. Poisson and logistic regression models respectively were fit to investigate factors associated with HSV-2 seropositivity and HIV MTCT. RESULTS Median maternal age was 27 years (IQR 24-31), 53% (796/1513) had been diagnosed with HIV during their most recent pregnancy and 20% had a history of injecting drugs. Median antenatal CD4 count was 430 cells/mm(3) (IQR 290-580). Ninety-six percent had received antiretroviral therapy antenatally. HSV-2 seroprevalence was 68% (1026/1513). In adjusted analyses, factors associated with HSV-2 antibodies were history of pregnancy termination (APR 1.30 (95% CI 1.18-1.43) for ��� 2 vs. 0), having an HIV-positive partner (APR 1.15 (95% CI 1.05-1.26) vs partner's HIV status unknown) and HCV seropositivity (APR 1.23 (95 % CI 1.13-1.35)). The overall HIV MTCT rate was 2.80% (95% CI 1.98-3.84); no increased HIV MTCT risk was detected among HSV-2 seropositive women after adjusting for known risk factors (AOR 1.43 (95% CI 0.54-3.77). CONCLUSION No increased risk of HIV MTCT was detected among the 68% of HIV-positive women with antibodies to HSV-2, in this population with an overall HIV MTCT rate of 2.8%. Markers of ongoing sexual risk among HIV-positive HSV-2 seronegative women indicate the importance of interventions to prevent primary HSV-2 infection during pregnancy in this high-risk group.