Low HIV-1 Incidence Among Married Serodiscordant Couples in Pune, India

Mehendale, S; Ghate, Manisha; Kumar, B Kishore; Sahay, Seema; Gamble, Theresa; Godbole, Sheela; Thakar, Madhuri; Kulkarni, Sanjeevani; Gupta, Amita; Gangakhedkar, R. R.; Divekar, A; Risbud, Arun; Paranjape, Ramesh; Bollinger, Robert C.

doi:10.1097/01.qai.0000209905.35620.48

Cited by 31 publications

(29 citation statements)

References 8 publications

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“…The core components of VCT studies included individual and couples HIV (rapid) testing and counseling, education and role-play (skills-building and self-efficacy), condom distribution, and information and referral for treatment, where necessary [12, 17, 20, 21, 27, 29, 30, 50–57]. …”

Section: Resultsmentioning

confidence: 99%

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Systematic Review of Couple-Based HIV Intervention and Prevention Studies: Advantages, Gaps, and Future Directions

2014

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We conducted a systematic review of couple-based HIV biobehavioral (skills-building, VCT, and adherence) and biomedical (ART, circumcision) prevention and intervention studies designed to reduce sexual-and drug-risk behaviors and HIV transmission and acquisition. Of the 11,162 papers identified in the search, 93 peer-reviewed papers met the inclusion criteria and yielded a total of 33 studies conducted globally. Biobehavioral couple-based prevention and intervention studies have been efficacious in reducing sexual- and drug-risk behaviors, increasing access to HIV testing and care, and improving adherence. Biomedical couple-based studies were found to reduce HIV incidence among HIV-negative sex partners and viral load among HIV-positive partners. Despite much progress, couple-based HIV prevention and intervention studies remain limited; a number of methodological gaps exist and studies focusing on MSM, people who inject drugs, and sex workers are scarce.

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Section: Resultsmentioning

confidence: 99%

“…Among the VCT studies, several studies were unclear or lacked sufficient information about their inclusion and exclusion criteria [17, 27, 52, 54, 56, 65]. Nearly all studies had clear/good sampling procedures and reported attrition and loss to follow-up, and all used appropriate data analytical approaches.…”

Section: Resultsmentioning

confidence: 99%

Systematic Review of Couple-Based HIV Intervention and Prevention Studies: Advantages, Gaps, and Future Directions

2014

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“…In 2002-2003, limited data pointed to several sizeable and growing concentrated HIV epidemics in the south and north-east parts of India, largely driven by core and bridge group interactions [21][22][23][24][25][26]. Internationally, there were projections of a massive HIV epidemic in India [27,28].…”

Section: Avahan the India Aids Initiativementioning

confidence: 99%

Evaluation design for large-scale HIV prevention programmes: the case of Avahan, the India AIDS initiative

Chandrasekaran¹,

Dallabetta²,

Loo³

et al. 2008

Aids

112

114

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“…[19]. The typical route of HIV transmission has been through unprotected heterosexual intercourse [20]; however, data about the incidence and risk factors associated with HIV transmission through heterosexual intercourse in India remains very limited [21]. The social construct of gender in India, which has evolved over many centuries, makes women highly vulnerable to HIV and other STIs [22].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for HIV transmission among heterosexual discordant couples in South India^*

et al. 2010

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ObjectiveTo assess the risk factors associated with heterosexual HIV transmission among South Indian discordant couples enrolled in clinical care. MethodsA nested matched case-control study of serodiscordant couples in which the HIV-infected partner (index case) was enrolled in care. Demographic and clinical characteristics, sexual behaviours, CD4 cell count and plasma HIV-1 RNA loads were measured at enrolment and longitudinally over 12 months of follow-up. The study included 70 cases who seroconverted during study follow-up and 167 matched controls who remained persistently serodiscordant. ResultsThe incidence of HIV infection among the initially seronegative partners was 6.52 per 100 personyears. Persistently discordant patients were more likely to have initiated highly active antiretroviral therapy (HAART) than patients in seroconverting relationships (62.9% vs. 42.9%) (P50.001). Patients in seroconverting relationships had significantly higher plasma viral loads (PVLs) than patients in discordant relationships at enrolment, at 6 months and at 12 months (Po0.05). Patients in seroconverting relationships were less likely to use condoms with their primary partners than patients in discordant relationships (Po0.05). Patients in relationships that seroconverted between 6 and 12 months were diagnosed more often with genital Herpes simplex than patients in discordant relationships (P50.001). In the univariate and multivariate logistic regression, the following variables were associated with seroconversion: PVL 4100 000 [odds ratio (OR): 1.82; 95% confidence interval (CI): 1.1-2.8], non-disclosure of HIV status (OR: 5.5; 95% CI: 4.3-6.2) and not using condoms (OR: 2.8; 95% CI: 2.4-3.6). ConclusionsCouples-based intervention models are crucial in preventing HIV transmission to seronegative spouses. Providing early treatment for sexually transmitted infections, HAART and enhancing condom use and disclosure could potentially decrease the risk of HIV transmission within Indian married couples. IntroductionAn increasing focus of HIV preventive strategies has been to move away from solely reducing the risk-taking behaviours of HIV-uninfected individuals to focusing on HIV-infected individuals who may continue to practice HIV risk-taking behaviours [1]. Studies from the developed and developing world have documented that a sizeable number of HIV-infected individuals continue to engage in unprotected sexual intercourse with HIV-serodiscordant partners [2][3][4][5][6]. Unprotected intercourse may be more common among HIV-infected individuals in steady or regular relationships than in casual or non-regular sexual *The first two authors contributed equally to this manuscript. [19]. The typical route of HIV transmission has been through unprotected heterosexual intercourse [20]; however, data about the incidence and risk factors associated with HIV transmission through heterosexual intercourse in India remains very limited [21]. The social construct of gender in India, which has evolved over many centuries, makes women highl...

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Low HIV-1 Incidence Among Married Serodiscordant Couples in Pune, India

Cited by 31 publications

References 8 publications

Systematic Review of Couple-Based HIV Intervention and Prevention Studies: Advantages, Gaps, and Future Directions

Systematic Review of Couple-Based HIV Intervention and Prevention Studies: Advantages, Gaps, and Future Directions

Evaluation design for large-scale HIV prevention programmes: the case of Avahan, the India AIDS initiative

Risk factors for HIV transmission among heterosexual discordant couples in South India^*

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Low HIV-1 Incidence Among Married Serodiscordant Couples in Pune, India

Cited by 31 publications

References 8 publications

Systematic Review of Couple-Based HIV Intervention and Prevention Studies: Advantages, Gaps, and Future Directions

Systematic Review of Couple-Based HIV Intervention and Prevention Studies: Advantages, Gaps, and Future Directions

Evaluation design for large-scale HIV prevention programmes: the case of Avahan, the India AIDS initiative

Risk factors for HIV transmission among heterosexual discordant couples in South India*

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Product

Resources

About

Risk factors for HIV transmission among heterosexual discordant couples in South India^*