Using a set of statistical methods and HIV mathematical models applied on nationally representative Demographic and Health Survey data, we characterized HIV serodiscordancy patterns and HIV transmission dynamics in stable couples (SCs) in four countries: Cambodia, the Dominican Republic, Haiti, and India. The majority of SCs affected by HIV were serodiscordant, and about a third of HIV-infected persons had uninfected partners.
Overall, nearly two-thirds of HIV infections occurred in individuals in SCs, but only about half of these infections were due to transmissions within serodiscordant couples. The majority of HIV incidence in the population occurred through extra-partner encounters in SCs.
There is similarity in HIV epidemiology in SCs between these countries and countries in sub-Saharan Africa, despite the difference in scale of epidemics. It appears that HIV epidemiology in SCs may share similar patterns globally, possibly because it is a natural 'spillover' effect of HIV dynamics in high-risk populations.
Below: Patterns of HIV serodiscordancy in India, Cambodia, the Dominican Republic, and Haiti compared to those in low and high HIV prevalence countries in sub-Saharan Africa. Countries are shown in order of increasing HIV prevalence
Below: HIV incidence and its sources in stable couples. (a) Fraction of new HIV infections in stable HIV serodiscordant couples that are due to sources external vs. internal to the couple. Estimates are shown for HIV incidence arising in stable HIV serodiscordant couples due to sources external to the couple. (b–h) The mean country-specific contributions to HIV incidence in the population stratified by couples' serostatus and source of HIV infection. Results are displayed for India, Cambodia, the Dominican Republic, and Haiti, compared to those in low and high HIV prevalence countries in sub-Saharan African. Countries are shown in order of increasing HIV prevalence.
Full article at: http://goo.gl/YmTqBv
- 1Infectious Disease Epidemiology Group,Weill Cornell Medical College - Qatar,Cornell University,Qatar Foundation - Education City,Doha,Qatar.
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