HIV-1 and HSV-2 are frequent genital co-infections in women. genital swabs: 74.5% of self-collected genital swabs and 63.6% of cervicovaginal lavage experienced detectable HIV-1 (p?≤?0.001 Fisher’s exact test) and 29.7% of self-collected genital swabs and 19.3% of cervicovaginal lavage experienced detectable HSV-2 (p?≤?0.001) in the placebo month. Cervicovaginal lavage and self-collected genital swabs computer virus levels were correlated (Spearman’s rho 0.68 for HIV; 0.61 for HSV-2) and self-collected genital swabs levels were generally higher. In multivariate modeling self-collected genital swabs and cervicovaginal lavage could equally detect the virus-suppressive effect of acyclovir: for HIV-1 proportional odds ratios were 0.42 and 0.47 and for HSV-2 they were 0.10 and 0.03 for self-collected genital swabs and cervicovaginal lavage respectively. Self-collected genital swabs should be considered for detection and measurement of HIV-1 and HSV-2 in SB-262470 clinical trials and other studies as they are a sensitive method to detect virus and can be collected in the home with frequent sampling. Keywords: Computer virus polymerase chain reaction sampling sexually transmitted infection ano-genital transmission self-collection Introduction HIV-1 transmission is usually strongly associated with genital HIV-1 shedding1 2 and many efforts SB-262470 to reduce transmission focus on reducing genital shedding. Treatment of HIV-infected persons with anti-retroviral drugs reduces viral burden genital shedding and HIV-1 transmission.3 However efforts to reduce HIV-1 transmission by targeting HSV-2 have so far failed 4 even though HSV-2 is associated with HIV-1 acquisition and transmission (examined in Barnabas and Celum5) and anti-HSV-2 treatment reduces HIV-1 shedding.6-9 Detection and measurement of HIV-1 and HSV-2 at mucosal sites is critical to understanding SB-262470 factors that affect their shedding. Methods that sample genital sites frequently without requiring visits to a supplier such as self-obtained vaginal samples 10 are particularly useful since genital HIV-1 and HSV-2 shedding varies in relation KGF to many factors11 12 (examined in Barnabas and SB-262470 Celum5). Cervicovaginal lavage (CVL) SB-262470 cervical and endocervical swabs have been used as the primary sampling methods for HIV-1 detection and quantitation in clinical trials.10 13 Assaying CVL showed the HIV-suppressive effect of acyclovir in HIV-1 and HSV-2 co-infected women in Thailand.8 This sample required a weekly clinic visit and collection by a physician or other trained provider. During the trial self-collected genital swabs (SCS) were also obtained18 to allow comparison with CVL. Although CVL have the advantage of a larger sample volume than swabs some studies have shown equivalent or higher HIV-1 detection rates with cervical or endocervical swabs.13 14 Wicks sponges and self-collected vaginal tampons have also been utilized for HIV-1 detection. 10 16 17 While self-collected samples can be obtained frequently at home they require training of subjects. Maintenance of cold-chain storage may be challenging in warm climates but preservatives can improve specimen quality. SCS have been widely accepted for studies of HSV-2 (examined in Barnabas and Celum5). We compared same-day collected CVL and SCS for three genital HIV-1 and HSV-2 outcomes: frequency of detection; viral weight; and ability to detect the suppressive effect of acyclovir. We also evaluated SB-262470 the acceptability and feasibility of SCS. Methods We enrolled 67 women co-infected with HIV-1- and HSV-2 in a clinical trial of suppressive acyclovir in Chiang Rai Thailand (“type”:”clinical-trial” attrs :”text”:”NCT00362596″ term_id :”NCT00362596″NCT00362596 at www.clinicaltrials.gov and 8). At baseline median CD4 count was 366 cells/μl plasma HIV-1 viral weight was 4.6 log10 copies/ml and baseline plasma viral weight was associated with HIV-1 shedding in SCS.18 Women did not receive ART during the trial. They received acyclovir or placebo the first month no product the second month and crossed over to placebo or acyclovir the third month. Women were trained in collection of SCS and clarified interview questions about acceptability. The study received ethical approval by the Thailand Ministry of General public Health and the Centers for Disease Control and.