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

Davey, D.L.J., Wall, K.M., Kilembe, W., et al. Journal of Acquired Immune Deficiency Syndromes (October 2017), 76(2): 123–131.

This study examined incidence of HIV infection from an outside partner and factors associated with HIV acquisition among cohabiting serodiscordant couples in Zambia. Among 3,049 serodiscordant couples, 478 tested HIV-positive; and analysis showed that 100 of these were infected by an outside partner. Men were more likely than women to contract HIV from an outside partner (24 percent versus 18 percent). Women who remained HIV-negative were more likely than those who acquired HIV through an outside partner to be older and have more children, and to have lived with their partner for a longer time. Women who seroconverted with an outside partner were poorer; less educated; and more likely to drink heavily, have a history of sexually transmitted infections (STIs) or genital ulceration or inflammation, and use oral contraceptive pills. Men who acquired HIV from an outside partner were more likely than those who remained negative to be younger and poorer, drink more heavily, and have a history of an STI or genital ulceration or inflammation. Pre-exposure prophylaxis interventions among serodiscordant couples may need to be adapted when outside sexual relationships are present. HIV-negative partners in serodiscordant relationships should also be routinely screened for STIs and genital inflammation to reduce HIV risk.

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