Abstract
Background. Most HIV-1 transmission in Africa occurs among HIV-1-discordant couples (one partner HIV-1 infected and one uninfected) who are unaware of their discordant HIV-1 serostatus. Given the high HIV-1 incidence among HIV-1 discordant couples and to assess efficacy of interventions for reducing HIV-1 transmission, HIV-1 discordant couples represent a critical target population for HIV-1 prevention interventions and prevention trials. Substantial regional differences exist in HIV-1 prevalence in Africa, but regignal differences in HIV-1 discordance among African couples, has not previously been reported. Methodology & Principal Findings. The Partners in Prevention HSV-2/ HIV-1 Transmission Trial ("Partners HSV-2 Study"), the first large HIV-1 prevention trial in Africa involving HIV-1 discordant couples, completed enrollment in May 200). Partners HSV-2 Study recruitment data from 12 sites from East and Southern Africa were used to assess HIV-1 discordance among couples accessing couples HIV-1 counseling and testing, and to correlate with enrollment of HIV-1 discordant couples. HIV-1 discordance at Partners HSV-2 Study sites ranged from 8-31% of couples tested from the community. Across all study sites and, among all couples with one HIV-1 infected partner, almost half (49%) of couples were HIV-1 discordant. Site-specific monthly enrollment of HIV-1 discordant couples into the clinical trial was not directly associated with prevalence of HIV-1 discordance, but was modestly correlated with national HIV-1 counseling and testing rates and access to palliative care/basic health care (r=0.74, p=0.09). Conclusions/Significance. HIV-1 discordant couples are a critical target for HIV-1 prevention in Africa. In addition to community prevalence of HIV-1 discordance, national infrastructure for HIV-1 testing and healthcare delivery and effective community outreach strategies impact recruitment of HIV-1 discordant couples into HIV-1 prevention trials.
| Original language | English |
|---|---|
| Article number | e1411 |
| Journal | PLoS One |
| Volume | 3 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 9 2008 |
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ASJC Scopus subject areas
- Agricultural and Biological Sciences(all)
- Biochemistry, Genetics and Molecular Biology(all)
- Medicine(all)
Cite this
Regional differences in prevalence of HIV-1 discordance in Africa and enrollment of HIV-1 discordant couples into an HIV-1 prevention trial. / Lingappa, Jairam R.; Lambdin, Barrot; Bukusi, Elizabeth Ann; Ngure, Kenneth; Kavuma, Linda; Inambao, Mubiana; Kanweka, William; Allen, Susan; Kiarie, James N.; Makhema, Joseph; Were, Edwin; Manongi, Rachel; Coetzee, David; de Bruyn, Guy; Delany-Moretlwe, Sinead; Magaret, Amalia; Mugo, Nelly; Mujugira, Andrew; Ndase, Patrick; Celum, Connie; Cohen, Craig; Farquhar, Carey; John-Stewart, Grace; Katabira, Elly; Ronald, Allan; Essex, Max; Fife, Kenneth; Kapiga, Saidi; deKock, Alana; Gray, Glenda; McIntyre, James; Rees, Helen.
In: PLoS One, Vol. 3, No. 1, e1411, 09.01.2008.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Regional differences in prevalence of HIV-1 discordance in Africa and enrollment of HIV-1 discordant couples into an HIV-1 prevention trial
AU - Lingappa, Jairam R.
AU - Lambdin, Barrot
AU - Bukusi, Elizabeth Ann
AU - Ngure, Kenneth
AU - Kavuma, Linda
AU - Inambao, Mubiana
AU - Kanweka, William
AU - Allen, Susan
AU - Kiarie, James N.
AU - Makhema, Joseph
AU - Were, Edwin
AU - Manongi, Rachel
AU - Coetzee, David
AU - de Bruyn, Guy
AU - Delany-Moretlwe, Sinead
AU - Magaret, Amalia
AU - Mugo, Nelly
AU - Mujugira, Andrew
AU - Ndase, Patrick
AU - Celum, Connie
AU - Cohen, Craig
AU - Farquhar, Carey
AU - John-Stewart, Grace
AU - Katabira, Elly
AU - Ronald, Allan
AU - Essex, Max
AU - Fife, Kenneth
AU - Kapiga, Saidi
AU - deKock, Alana
AU - Gray, Glenda
AU - McIntyre, James
AU - Rees, Helen
PY - 2008/1/9
Y1 - 2008/1/9
N2 - Background. Most HIV-1 transmission in Africa occurs among HIV-1-discordant couples (one partner HIV-1 infected and one uninfected) who are unaware of their discordant HIV-1 serostatus. Given the high HIV-1 incidence among HIV-1 discordant couples and to assess efficacy of interventions for reducing HIV-1 transmission, HIV-1 discordant couples represent a critical target population for HIV-1 prevention interventions and prevention trials. Substantial regional differences exist in HIV-1 prevalence in Africa, but regignal differences in HIV-1 discordance among African couples, has not previously been reported. Methodology & Principal Findings. The Partners in Prevention HSV-2/ HIV-1 Transmission Trial ("Partners HSV-2 Study"), the first large HIV-1 prevention trial in Africa involving HIV-1 discordant couples, completed enrollment in May 200). Partners HSV-2 Study recruitment data from 12 sites from East and Southern Africa were used to assess HIV-1 discordance among couples accessing couples HIV-1 counseling and testing, and to correlate with enrollment of HIV-1 discordant couples. HIV-1 discordance at Partners HSV-2 Study sites ranged from 8-31% of couples tested from the community. Across all study sites and, among all couples with one HIV-1 infected partner, almost half (49%) of couples were HIV-1 discordant. Site-specific monthly enrollment of HIV-1 discordant couples into the clinical trial was not directly associated with prevalence of HIV-1 discordance, but was modestly correlated with national HIV-1 counseling and testing rates and access to palliative care/basic health care (r=0.74, p=0.09). Conclusions/Significance. HIV-1 discordant couples are a critical target for HIV-1 prevention in Africa. In addition to community prevalence of HIV-1 discordance, national infrastructure for HIV-1 testing and healthcare delivery and effective community outreach strategies impact recruitment of HIV-1 discordant couples into HIV-1 prevention trials.
AB - Background. Most HIV-1 transmission in Africa occurs among HIV-1-discordant couples (one partner HIV-1 infected and one uninfected) who are unaware of their discordant HIV-1 serostatus. Given the high HIV-1 incidence among HIV-1 discordant couples and to assess efficacy of interventions for reducing HIV-1 transmission, HIV-1 discordant couples represent a critical target population for HIV-1 prevention interventions and prevention trials. Substantial regional differences exist in HIV-1 prevalence in Africa, but regignal differences in HIV-1 discordance among African couples, has not previously been reported. Methodology & Principal Findings. The Partners in Prevention HSV-2/ HIV-1 Transmission Trial ("Partners HSV-2 Study"), the first large HIV-1 prevention trial in Africa involving HIV-1 discordant couples, completed enrollment in May 200). Partners HSV-2 Study recruitment data from 12 sites from East and Southern Africa were used to assess HIV-1 discordance among couples accessing couples HIV-1 counseling and testing, and to correlate with enrollment of HIV-1 discordant couples. HIV-1 discordance at Partners HSV-2 Study sites ranged from 8-31% of couples tested from the community. Across all study sites and, among all couples with one HIV-1 infected partner, almost half (49%) of couples were HIV-1 discordant. Site-specific monthly enrollment of HIV-1 discordant couples into the clinical trial was not directly associated with prevalence of HIV-1 discordance, but was modestly correlated with national HIV-1 counseling and testing rates and access to palliative care/basic health care (r=0.74, p=0.09). Conclusions/Significance. HIV-1 discordant couples are a critical target for HIV-1 prevention in Africa. In addition to community prevalence of HIV-1 discordance, national infrastructure for HIV-1 testing and healthcare delivery and effective community outreach strategies impact recruitment of HIV-1 discordant couples into HIV-1 prevention trials.
UR - http://www.scopus.com/inward/record.url?scp=39049084537&partnerID=8YFLogxK
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U2 - 10.1371/journal.pone.0001411
DO - 10.1371/journal.pone.0001411
M3 - Article
VL - 3
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 1
M1 - e1411
ER -