OBJECTIVE: To determine risk factors for HIV transmission within married couples in four urban populations in sub-Saharan Africa. METHODS: Data from a cross-sectional population-based study were used. Representative random samples approximating 1000 men and 1000 women in each of four cities of Kisumu (Kenya), Ndola (Zambia), Cotonou (Benin), and Yaoundé (Cameroon), were interviewed and tested for sexually transmitted infections (STI). Married couples were identified as concordant negative, discordant, or concordant positive for each STI. After excluding concordant HIV negative couples, analysis of behavioural and STI risk factors for HIV positive concordancy was undertaken across the four cities and in each city separately where sample size allowed. RESULTS: Among 221 couples in which at least one member was HIV positive, we found that the only significant risk factor for positive HIV concordancy was herpes simplex type 2 (HSV-2) status. After adjusting for age and city of residence the odds ratio for HIV concordancy compared to couples with neither spouse HSV-2 positive was 3.4 (95% confidence interval, 0.62-18.4) for couples with one partner HSV-2 positive and 8.6 (95% confidence interval, 1.6-45.0) for couples with both partners HSV-2 positive. The same trends were seen in Kisumu and Ndola when they were analysed separately (numbers were small in the other cities). CONCLUSIONS: Although cross-sectional studies are not ideal for delineating the sequence of transmission events, this study adds to the evidence that HSV-2 is a key risk factor in promoting HIV transmission.
OBJECTIVE: To determine risk factors for HIV transmission within married couples in four urban populations in sub-Saharan Africa. METHODS: Data from a cross-sectional population-based study were used. Representative random samples approximating 1000 men and 1000 women in each of four cities of Kisumu (Kenya), Ndola (Zambia), Cotonou (Benin), and Yaoundé (Cameroon), were interviewed and tested for sexually transmitted infections (STI). Married couples were identified as concordant negative, discordant, or concordant positive for each STI. After excluding concordant HIV negative couples, analysis of behavioural and STI risk factors for HIV positive concordancy was undertaken across the four cities and in each city separately where sample size allowed. RESULTS: Among 221 couples in which at least one member was HIV positive, we found that the only significant risk factor for positive HIV concordancy was herpes simplex type 2 (HSV-2) status. After adjusting for age and city of residence the odds ratio for HIV concordancy compared to couples with neither spouse HSV-2 positive was 3.4 (95% confidence interval, 0.62-18.4) for couples with one partner HSV-2 positive and 8.6 (95% confidence interval, 1.6-45.0) for couples with both partners HSV-2 positive. The same trends were seen in Kisumu and Ndola when they were analysed separately (numbers were small in the other cities). CONCLUSIONS: Although cross-sectional studies are not ideal for delineating the sequence of transmission events, this study adds to the evidence that HSV-2 is a key risk factor in promoting HIV transmission.
Authors: Don C Des Jarlais; Courtney McKnight; Kamyar Arasteh; Jonathan Feelemyer; David C Perlman; Holly Hagan; Emily F Dauria; Hannah L F Cooper Journal: Subst Use Misuse Date: 2014-02-06 Impact factor: 2.164
Authors: Sophie J S Pascoe; Lisa F Langhaug; Webster Mavhu; James Hargreaves; Shabbar Jaffar; Richard Hayes; Frances M Cowan Journal: PLoS One Date: 2015-01-27 Impact factor: 3.240
Authors: Jairam R Lingappa; Erin Kahle; Nelly Mugo; Andrew Mujugira; Amalia Magaret; Jared Baeten; Elizabeth A Bukusi; Craig R Cohen; Elly Katabira; Allan Ronald; James Kiarie; Carey Farquhar; Grace John Stewart; Joseph Makhema; M Essex; Edwin Were; Kenneth Fife; Guy Debruyn; Glenda Gray; James McIntyre; Rachel Manongi; Saidi Kapiga; David Coetzee; Susan Allen; Mubiana Inambao; Kayitesi Kayitenkore; Etienne Karita; William Kanweka; Sinead Delany; Helen Rees; Bellington Vwalika; Robert W Coombs; Rhoda Morrow; William Whittington; Lawrence Corey; Anna Wald; Connie Celum Journal: PLoS One Date: 2009-04-30 Impact factor: 3.240
Authors: Jairam R Lingappa; Barrot Lambdin; Elizabeth Ann Bukusi; Kenneth Ngure; Linda Kavuma; Mubiana Inambao; William Kanweka; Susan Allen; James N Kiarie; Joseph Makhema; Edwin Were; Rachel Manongi; David Coetzee; Guy de Bruyn; Sinead Delany-Moretlwe; Amalia Magaret; Nelly Mugo; Andrew Mujugira; Patrick Ndase; Connie Celum Journal: PLoS One Date: 2008-01-09 Impact factor: 3.240