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High proportion of HIV serodiscordance among HIV-affected married couples in northern Vietnam.

ABSTRACT: Little is known about the state of HIV transmission among married couples in Vietnam. This study aims to clarify HIV serostatus in this group and elucidate risk factors for intra-marital HIV transmission.In 2012, we enrolled a group of HIV-positive married men registered at the HIV outpatient clinic of a referral hospital in northern Vietnam, along with their wives. Sociodemographic, behavioural and clinical data were collected from men and wives. HIV serodiscordant couples were followed until March 2014 to determine seroconversion rate. A phylogenetic analysis was performed based on env V3 sequence to detail cluster formation among men.Of the 163 HIV-positive men enrolled in the study, 101 (62.0%) had wives testing HIV-negative. Half of men reported injecting drug use (IDU) as a likely transmission route. Couples reported a high incidence of unprotected sexual intercourse prior to diagnosis; the median (inter quartile range) was 4 (4-8) times per month. Only 17 couples (10.4%) reported using condoms during at least half these instances. Multivariable analysis revealed IDU history among men was independently associated with HIV-negative wives (adjusted OR 0.31; 95% CI 0.10-0.95, p=0.041). Phylogenetic analysis of 80 samples indicated CRF01_AE. Of these, 69 (86.3%) clustered with IDU-associated viruses from Vietnam. No HIV seroconversion was identified during a follow-up of 61 serodiscordant couples, with 126.5 person-years of observation during which HIV-infected men were on antiretroviral drug therapy (ART).High HIV serodiscordance was observed among HIV-affected married couples in northern Vietnam. A large number of at-risk wives therefore remain HIV-negative and can be protected with measures including proper use of ART if couples are made aware of the serodiscordance through screening.

SUBMITTER: Sawada I

PROVIDER: S-EPMC4405585 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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High proportion of HIV serodiscordance among HIV-affected married couples in northern Vietnam.

Sawada Ikumi I Tanuma Junko J Do Cuong Duy CD Doan Tra Thu TT Luu Quynh Phuong QP Nguyen Lan Anh Thi LA Vu Tuong Van Thi TV Nguyen Tuan Quang TQ Tsuchiya Naho N Shiino Teiichiro T Yoshida Lay-Myint LM Pham Thanh Thuy Thi TT Ariyoshi Koya K Oka Shinichi S

PloS one 20150421 4

<h4>Introduction</h4>Little is known about the state of HIV transmission among married couples in Vietnam. This study aims to clarify HIV serostatus in this group and elucidate risk factors for intra-marital HIV transmission.<h4>Methods</h4>In 2012, we enrolled a group of HIV-positive married men registered at the HIV outpatient clinic of a referral hospital in northern Vietnam, along with their wives. Sociodemographic, behavioural and clinical data were collected from men and wives. HIV serodis ...[more]

PMID: 25898138

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Project description:BackgroundSubfertility among couples affected by HIV has an impact on the well-being of couples who desire to have children and may prolong HIV exposure. Subfertility in the antiretroviral therapy era and its determinants have not yet been well characterized.ObjectiveThe objective of the study was to investigate the burden and determinants of subfertility among HIV-affected couples seeking safer conception services in South Africa.Study designNonpregnant women and male partners in HIV seroconcordant or HIV discordant relationships desiring a child were enrolled in the Sakh'umndeni safer conception cohort at Witkoppen Clinic in Johannesburg between July 2013 and April 2017. Clients were followed up prospectively through pregnancy (if they conceived) or until 6 months of attempted conception, after which they were referred for infertility services. Subfertility was defined as not having conceived within 6 months of attempted conception. Robust Poisson regression was used to assess the association between baseline characteristics and subfertility outcomes; inverse probability weighting was used to account for missing data from women lost to safer conception care before 6 months of attempted conception.ResultsAmong 334 couples enrolled, 65% experienced subfertility (inverse probability weighting weighted, 95% confidence interval, 0.59-0.73), of which 33% were primary subfertility and 67% secondary subfertility. Compared with HIV-negative women, HIV-positive women not on antiretroviral therapy had a 2-fold increased risk of subfertility (weighted and adjusted risk ratio, 2.00; 95% confidence interval, 1.19-3.34). Infertility risk was attenuated in women on antiretroviral therapy but remained elevated, even after ≥2 years on antiretroviral therapy (weighted and adjusted risk ratio, 1.63; 95% confidence interval, 0.98-2.69). Other factors associated with subfertility were female age (weighted and adjusted risk ratio, 1.03, 95% confidence interval, 1.01-1.05 per year), male HIV-positive status (weighted and adjusted risk ratio, 1.31; 95% confidence interval, 1.02-1.68), male smoking (weighted and adjusted risk ratio, 1.29; 95% confidence interval, 1.05-1.60), and trying to conceive for ≥1 year (weighted and adjusted risk ratio, 1.38; 95% confidence interval, 1.13-1.68).ConclusionTwo in 3 HIV-affected couples experienced subfertility. HIV-positive women were at increased risk of subfertility, even when on antiretroviral therapy. Both male and female HIV status were associated with subfertility. Subfertility is an underrecognized reproductive health problem in resource-limited settings and may contribute to prolonged HIV exposure and transmission within couples. Low-cost approaches for screening and treating subfertility in this population are needed.

Project description:BackgroundPrevious studies suggest that having a marital partner with hypertension is associated with an individual's increased risk of hypertension, however this has not been investigated in sub-Saharan Africa despite hypertension being a common condition; the age-standardised prevalence of hypertension was 46.0% in 2013 in Namibia.ObjectiveTo explore whether there is spousal concordance for hypertension and hypertension control in Namibia.MethodsCouples data from the 2013 Namibia Demographic and Health Survey were analysed. Bivariable and multivariable logistic regression models were used to explore the odds of individual's hypertension based on their partner's hypertension status, 492 couples. and the odds of hypertension control in individuals based on their partner's hypertension control (121 couples), where both members had hypertension. Separate models were built for female and male outcomes for both research questions to allow independent consideration of risk factors to be analysed for female and males.ResultsThe unadjusted odds ratio of 1.57 (CI 1.10-2.24) for hypertension among individuals (both sexes) whose partner had hypertension compared to those whose partner did not have hypertension, was attenuated to aOR 1.35 (CI 0.91-2.00) for females (after adjustment for age, BMI, diabetes, residence, individual and partner education) and aOR 1.42 (CI 0.98-2.07) for males (after adjustment for age and BMI). Females and males were significantly more likely to be in control of their hypertension if their partner also had controlled hypertension, aOR 3.69 (CI 1.23-11.12) and aOR 3.00 (CI 1.07-8.36) respectively.ConclusionsHaving a partner with hypertension was positively associated with having hypertension among married Namibian adults, although not statistically significant after adjustment. Partner's hypertension control was significantly associated with individual hypertension control. Couples-focused interventions, such as routine partner screening of hypertensive individuals, could be developed in Namibia.

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High proportion of HIV serodiscordance among HIV-affected married couples in northern Vietnam.

Publications

High proportion of HIV serodiscordance among HIV-affected married couples in northern Vietnam.

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