Quantification of the role of discordant couples in driving incidence of HIV in sub-Saharan Africa.

نویسندگان

  • Brian J Coburn
  • David J Gerberry
  • Sally Blower
چکیده

Data presented in the meta-analysis by Oghenowede Eyawo and colleagues sheds new light on the role of serodiscordant couples in driving the incidence of HIV in Africa. The HIV epidemic in Africa is driven by heterosexual transmission. Studies have shown transmission in stable discordant couples can be as low as 1·9 per 100 person-years to as high as 19·0 per 100 person-years; these couples are typically in stable relationships lasting at least a year. However, the extent to which they drive countrylevel incidence in sub-Saharan Africa percentage of the population in stable relationships (regardless of whether they are in discordant or concordant couples), the more discordant couples drive incidence. Notably, their role in driving incidence is country-specifi c. For example, if 40% of the population in Ghana is in stable relationships, stable discordant couples could account for 34% of the country-level incidence. However, if the same percentage in Rwanda is in stable relationships, they could only account for 18% of the country-level incidence. Results from a previous study suggest transmission in stable discordant couples could account for about 50% of the countrylevel incidence. Our results show that such transmission is possible, but is more likely in some countries than in others; for example, it seems possible in Kenya but unlikely in Guinea (fi gure). We agree that public health programmes aimed at preventing HIV infection in stable discordant couples could be very useful in reducing transmission. However, determination of the degree to which these couples drive incidence of HIV in specifi c countries is crucial, because this will determine the necessity and intensity of other interventions. Figure: The proportion of country-level incidence of HIV due to transmission by stable discordant couples versus the proportion of the population in stable relationships lasting a year or more. Data includes concordant and discordant couples. SDC=stable discordant couple. Burkina Faso Ethiopia Guinea Kenya Malawi Rwanda Tanzania

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Quantification of the role of discordant couples in driving incidence of HIV in sub-Saharan Africa

Data presented in the meta-analysis by Oghenowede Eyawo and colleagues sheds new light on the role of serodiscordant couples in driving the incidence of HIV in Africa. The HIV epidemic in Africa is driven by heterosexual transmission. Studies have shown transmission in stable discordant couples can be as low as 1·9 per 100 person-years to as high as 19·0 per 100 person-years; these couples are ...

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عنوان ژورنال:
  • The Lancet. Infectious diseases

دوره 11 4  شماره 

صفحات  -

تاریخ انتشار 2011