Distinct HIV discordancy patterns by epidemic size in stable sexual partnerships in sub-Saharan Africa

Hiam Chemaitelly, Ide Cremin, Jim Shelton, Timothy B. Hallett, Laith Aburaddad

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58 Citations (Scopus)

Abstract

Objective: To describe patterns of HIV infection among stable sexual partnerships across sub-Saharan Africa (SSA). Methods: The authors defined measures of HIV discordancy and conducted a comprehensive quantitative assessment of discordancy among stable partnerships in 20 countries in SSA through an analysis of the Demographic and Health Survey data. Results: HIV prevalence explained at least 50% of the variation in HIV discordancy, with two distinct patterns of discordancy emerging based on HIV prevalence being roughly smaller or larger than 10%. In low-prevalence countries, approximately 75% of partnerships affected by HIV are discordant, while only about half of these are discordant in high-prevalence countries. Out of each 10 HIV infected persons, two to five are engaged in discordant partnerships in low-prevalence countries compared with one to three in high-prevalence countries. Among every 100 partnerships in the population, one to nine are affected by HIV and zero to six are discordant in low-prevalence countries compared with 16-45 and 9-17, respectively, in high-prevalence countries. Finally, zero to four of every 100 sexually active adults are engaged in a discordant partnership in low-prevalence countries compared with six to eight in high-prevalence countries. Conclusions: In high-prevalence countries, a large fraction of stable partnerships were affected by HIV and half were discordant, whereas in low-prevalence countries, fewer stable partnerships were affected by HIV but a higher proportion of them were discordant. The findings provide a global view of HIV infection among stable partnerships in SSA but imply complex considerations for rolling out prevention interventions targeting discordant partnerships.

Original languageEnglish
Pages (from-to)51-57
Number of pages7
JournalSexually Transmitted Infections
Volume88
Issue number1
DOIs
Publication statusPublished - Feb 2012

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Africa South of the Sahara
HIV
HIV Infections
Demography

ASJC Scopus subject areas

  • Dermatology
  • Infectious Diseases

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Distinct HIV discordancy patterns by epidemic size in stable sexual partnerships in sub-Saharan Africa. / Chemaitelly, Hiam; Cremin, Ide; Shelton, Jim; Hallett, Timothy B.; Aburaddad, Laith.

In: Sexually Transmitted Infections, Vol. 88, No. 1, 02.2012, p. 51-57.

Research output: Contribution to journalArticle

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abstract = "Objective: To describe patterns of HIV infection among stable sexual partnerships across sub-Saharan Africa (SSA). Methods: The authors defined measures of HIV discordancy and conducted a comprehensive quantitative assessment of discordancy among stable partnerships in 20 countries in SSA through an analysis of the Demographic and Health Survey data. Results: HIV prevalence explained at least 50{\%} of the variation in HIV discordancy, with two distinct patterns of discordancy emerging based on HIV prevalence being roughly smaller or larger than 10{\%}. In low-prevalence countries, approximately 75{\%} of partnerships affected by HIV are discordant, while only about half of these are discordant in high-prevalence countries. Out of each 10 HIV infected persons, two to five are engaged in discordant partnerships in low-prevalence countries compared with one to three in high-prevalence countries. Among every 100 partnerships in the population, one to nine are affected by HIV and zero to six are discordant in low-prevalence countries compared with 16-45 and 9-17, respectively, in high-prevalence countries. Finally, zero to four of every 100 sexually active adults are engaged in a discordant partnership in low-prevalence countries compared with six to eight in high-prevalence countries. Conclusions: In high-prevalence countries, a large fraction of stable partnerships were affected by HIV and half were discordant, whereas in low-prevalence countries, fewer stable partnerships were affected by HIV but a higher proportion of them were discordant. The findings provide a global view of HIV infection among stable partnerships in SSA but imply complex considerations for rolling out prevention interventions targeting discordant partnerships.",
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