MSC (Med),Population-Based Epidemiology, Faculty of Health Sciences, University of the Witwatersrand, 2007 / Objective
To compare risk factors between HIV-positive concordant and discordant couples.
Study design
This is a cross-sectional secondary data analysis study using data from Africa Centre
Demographic Information System (ACDIS) database (June 2003 to December 2004)
and data from the first round of population-based HIV surveillance conducted by the
Africa Centre for Health and Population Studies.
Methods
Eighty-five HIV-positive concordant couples (both partners were HIV-positive) and
73 discordant couples (one partner was HIV-positive and other partner HIV-negative)
were identified and selected from the first round of population-based HIV
surveillance conducted from June 2003 to December 2004 in Hlabisa Demographic
Surveillance System site. Partners health and sexual behaviour data were collected
together with the blood sample for HIV test during the same round. Socio-economic
and demographic data of partners were obtained from the ACDIS database and were
collected within the same period (June 2003 to December 2004).
The behavioural, biological, demographic and socio-economic risk factors for HIVpositive
concordance and transmission within discordant couples were analysed.
Circumcision and area of residence respectively were the biological and demographic
factors considered. Number of household assets was used as a proxy for socioeconomic
status. The behavioural factors considered were male condom-use, sexual
debut (age at first sex), number of lifetime partners and premarital partners. The age
and educational level of partners were considered as potential confounders.
5
RESULTS
The uncircumcised men were more likely to be in HIV-positive concordant couples
than to be in discordant couples (OR =10.8, 95% CI [1.93 – 60.30], p=0.007).
Partners living in urban area were 4.7 times more at risk of being in a HIV-positive
concordant relationship than to be in discordant relationship (OR=4.7, 95% CI [2.09 -
10.39], p<0.001). Male not using condom on regular basis with female partners, early
sexual debut, greater number of premarital partners, household assets and lifetime
partners were found not to be significantly associated with HIV-positive concordance.
Conclusion
There are several biologic, socio-economic, demographic and behavioural risk factors
for HIV-positive concordance. However, identifying some of them might be used to
address transmission of HIV among discordant couples through intervention
programs. Although cross-sectional studies are not ideal for establishing temporality,
this study corroborates the findings of other studies that living in urban areas and
circumcision are associated with HIV transmission.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/7587 |
| Date | 02 March 2010 |
| Creators | Adjei, George |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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