Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Randomized, Cross-Over Study to Evaluate the Suppressive Effect of High-Dose Acyclovir Versus Once Daily Valacyclovir on Herpes Simplex Virus Type 2 Genital Shedding in Herpes Simplex Virus-2 Seropositive Adults
Brief Summary: The purpose of the research study is to evaluate the effectiveness of high-dose acyclovir compared to valacyclovir for reduction of asymptomatic genital shedding in persons with genital herpes.

The study will enroll men and women who are 18 years or older, test positive to HSV-2 (by blood test) and have had a first outbreak of HSV-2 within the past 6 months or have had at least 4 genital herpes outbreaks in the past year. Participants must be HIV negative and willing to stop taking suppressive therapy for HSV for the one week wash out period. (Females only: You must not be pregnant or breast-feeding). Both men and women will be asked to use an effective form of birth control.

Involvement in the study will last 15-weeks and you will be asked to visit the clinic every 2-weeks. At each visit, you will be given medication to take daily (either valacyclovir or acyclovir; you will receive both medications at some point during this study). There will be a total of 9 study visits and each visit will last approximately 30 minutes. We will ask that you complete a daily symptom diary and collected daily home swabs 4-times a day, everyday during the study. Each daily home swab will take less than 3 minutes to perform.


Options:
A: Inclusion Criteria:

1. 18 years or older;
2. HSV-2 seropositive by Western Blot;
3. not receiving any drugs with known anti-HSV-2 activity for study duration;
4. history of primary genital herpes infection within past 6 months OR history of 4 or more HSV recurrences per year during the past year OR 4 or more recurrences per year prior to initiation of suppressive antiviral therapy;
5. able to comply with the study protocol;
6. women of child bearing potential who are sexually active with men must be using a medically accepted method of contraception as judged by the investigator;
7. women of child-bearing potential must have a negative pregnancy test (urine) at screening visit;
8. in general good health, without other serious medical conditions and specifically with normal renal and hepatic function, as determined by the patient's medical history;
9. planning to remain resident in the area of the study center for the duration of the study participation;
10. HIV seronegative.

Exclusion Criteria:

1. hypersensitivity to acyclovir or valacyclovir;
2. pregnant women;
3. HIV positive or other immunosuppressed state, including chronic steroid use. Intermittent nasal or topical steroids are acceptable
B: Inclusion Criteria:

* 18 years or older;
* HSV-2 seropositive by Western Blot;
* not receiving any drugs with known anti-HSV-2 activity for study duration;
* history of primary genital herpes infection within past 6 months OR history of 4 or more HSV recurrences per year during the past year OR 4 or more recurrences per year prior to initiation of suppressive antiviral therapy; or shedding HSV-2 from genital mucosa on \>25% of days in shedding session performed at the VRC within the last 2 years.
* able to comply with the study protocol;
* women of child bearing potential who are sexually active with men must be using a medically accepted method of contraception as judged by the investigator;
* women of child-bearing potential must have a negative pregnancy test (urine) at screening visit;
* in general good health, without other serious medical conditions and specifically with normal renal and hepatic function, as determined by the patient's medical history;
* planning to remain resident in the area of the study center for the duration of the study participation;
* HIV seronegative.

Exclusion Criteria:

* hypersensitivity to acyclovir or valacyclovir;
* pregnant women;
* HIV positive or other immunosuppressed state, including chronic steroid use. Intermittent nasal or topical steroids are acceptable
C: Inclusion Criteria:

* Infection with HIV-1 and HSV-2
* If required to take antiretrovirals according to WHO recommendations, should be on HAART for at least 4 months
* Written informed consent

Exclusion Criteria:

* Pregnancy or willing to be pregnant during the next 6 months
* Breastfeeding
* Renal failure
* Expected non-compliance with follow-up or study treatment
D: Inclusion Criteria:

MALES randomized to circumcision:

* Age 15-49
* Able and willing to provide written informed consent
* Have no medical contraindications to male circumcision

FEMALE partners:

* Able and willing to provide written informed consent
* No age limit

Exclusion Criteria:

* Medical contraindications, including penile pathology or anemia (males). Unable or unwilling to provide informed consent.

Please note: for participants under age 18, the study follows informed consent/assent procedures as required under US Federal Regulations. The latter are also consistent with Ugandan policy.

Answer: A