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P3.206 Characterizing HIV Sero-Discordancy Among Stable Couples in Cambodia, the Dominican Republic, Haiti, and India
  1. H Chemaitelly1,
  2. L J Abu-Raddad1,2,3
  1. 1Infectious Disease Epidemiology Group, Weill Cornell Medical College-Qatar, Doha, Qatar
  2. 2Department of Public Health, Weill Cornell Medical College, Cornell University, New York, NY, United States
  3. 3Vaccine and Infectious Disease Institute, Fred Hutchinson Cancer Research Center, Seattle, WA, United States

Abstract

Background Characterizing the epidemiology of HIV sero-discordancy among stable couples (SCs) is essential to inform HIV policy and programming, especially considering the recent availability of efficacious interventions among stable HIV sero-discordant couples (SDCs). This work complements a quantitative assessment of HIV sero-discordancy among SCs in sub-Saharan Africa (SSA), by analysing sero-discordancy in all countries outside SSA for which HIV biomarker demographic and health surveys (DHS) are available.

Methods We derived measures of HIV sero-discordancy using nationally-representative DHS data for Cambodia, the Dominican Republic (DR) including a sub-population at higher risk of HIV (Bateyes-DR), Haiti, and India. Vietnam was excluded from our analysis because of the low number of couples affected by HIV (3 couples).

Results HIV was more prevalent in Bateyes-DR (3.3%) and Haiti (2.2%) than in other settings (< 1%). About two-third of the population in reproductive age in these countries were engaged in SCs. The proportions of SCs affected by HIV and of SDCs were, respectively, 5.7% and 4.2% (Bateyes-DR), 4.7% and 3.2% (Haiti), 1.2% and 0.9% (DR), 1.0% and 0.5% (Cambodia), and 0.5% and 0.4% (India). Among SCs affected by HIV, 74.3% were sero-discordant in Bateyes-DR compared to 68.3% in Haiti, 70.1% in DR, 51.6% in Cambodia, and 78.5% in India. About a third of HIV sero-positive persons had uninfected partners: 38.3% (Bateyes-DR), 35.4% (Haiti), 33.3% (DR), 32.1% (Cambodia), and 39.6% (India). Limited sero-discordancy was observed at the population-level with at most two out of every 100 adults in reproductive age being engaged in a SDC.

Conclusions Our findings are consistent with HIV sero-discordancy patterns in low prevalence settings in SSA. While the large sero-discordancy among SCs affected by HIV offers an opportunity for HIV prevention, the small number of SCs affected by HIV at the population-level suggests logistical difficulties for implementing SDC-targeted prevention interventions in these countries.

  • Couples
  • HIV
  • Sero-discordancy

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