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HIV Incidence and Predictors of HIV Acquisition From an Outside Partner in Serodiscordant Couples in Lusaka, Zambia.

Authors :
Joseph Davey, Dvora L
Joseph Davey, Dvora L
Wall, Kristin M
Kilembe, William
Naw, Htee Khu
Brill, Ilene
Vwalika, Bellington
Chomba, Elwyn
Mulenga, Joseph
Tichacek, Amanda
Javanbakt, Marjan
Gorbach, Pamina M
Allen, Susan A
Joseph Davey, Dvora L
Joseph Davey, Dvora L
Wall, Kristin M
Kilembe, William
Naw, Htee Khu
Brill, Ilene
Vwalika, Bellington
Chomba, Elwyn
Mulenga, Joseph
Tichacek, Amanda
Javanbakt, Marjan
Gorbach, Pamina M
Allen, Susan A
Source :
Journal of acquired immune deficiency syndromes (1999); vol 76, iss 2, 123-131; 1525-4135
Publication Year :
2017

Abstract

ObjectiveEvaluate the incidence and predictors of HIV acquisition from outside partners in serodiscordant couples.MethodsDemographic, behavioral, and clinical exposures were measured quarterly in a cohort of serodiscordant cohabiting couples in Zambia from 1995 to 2012 (n = 3049). Genetic analysis classified incident infections as those acquired from the study partner (linked) or acquired from an outside partner (unlinked). Factors associated with time to unlinked HIV infection were evaluated using multivariable Cox proportional hazards regression stratified by sex.ResultsThere were 100 unlinked infections in couples followed for a median of 806 days. Forty-five infections occurred in women [1.85/100 couple-years; 95% confidence interval (CI): 1.35 to 2.47]. Risk of female unlinked infection (vs. nonseroconverting females) was associated with reporting being drunk weekly/daily vs. moderate/nondrinkers at baseline [adjusted hazard ratio (aHR) = 5.44; 95% CI: 1.03 to 28.73], genital ulcers (aHR = 6.09; 95% CI: 2.72 to 13.64), or genital inflammation (aHR = 11.92; 95% CI: 5.60 to 25.37) during follow-up adjusting for age, years cohabiting, income, contraceptive use, previous pregnancies, history of sexually transmitted infections, and condomless sex with study partner. Fifty-five infections occurred in men (1.82/100 couple-years; 95% CI: 1.37 to 2.37). Risk of male unlinked infection was associated with genital inflammation (aHR = 8.52; 95% CI: 3.82 to 19.03) or genital ulceration (aHR = 2.31; 95% CI: 2.05 to 8.89), reporting ≥1 outside sexual partner (aHR = 3.86; 95% CI: 0.98 to 15.17) during follow-up, and reporting being drunk weekly/daily vs. moderate/nondrinkers at baseline (aHR = 3.84; 95% CI: 1.28 to 11.55), controlling for age, income, circumcision status, and history of sexually transmitted infection.ConclusionsPredictors of unlinked infection in serodiscordant relationships were alcohol use, genital inflammation, and ulceration. Causes of genital inflammation

Details

Database :
OAIster
Journal :
Journal of acquired immune deficiency syndromes (1999); vol 76, iss 2, 123-131; 1525-4135
Notes :
application/pdf, Journal of acquired immune deficiency syndromes (1999) vol 76, iss 2, 123-131 1525-4135
Publication Type :
Electronic Resource
Accession number :
edsoai.on1391613264
Document Type :
Electronic Resource