Heterosexual transmission of HIV among married couples is the commonest mode of transmission seen in India. Intramarital transmission is associated with several challenges which need to be further researched. Their spouses were tested for HIV. A structured proforma was used to study various factors like condom use, circumcision, and the presence of sexually transmitted infections.
Ninety-one monogamous married cohabiting HIV-positive cases were included in the study and considered as index cases. There were 51 males and 40 females. Evidence of STD was observed in one of the spouses in 6 out of 55 seroconcordant couples and 6 out of 36 serodiscordant couples. Thus, out of 91 couples one of the partners was having STI in 12 couples. Overall rate of circumcision was Serodiscordant couples, specially the HIV negative female partner is at higher risk.
Less acceptability of condoms among Hiv heterosexual transmission probability quantum couples may be one of the factors responsible in transmission.
Further studies are needed to explore other risk factors associated with HIV transmission in discordant couples. This can be influenced by factors such as condom use, the presence of sexually transmitted diseases, circumcision, etc.
Hiv heterosexual transmission probability quantum these Hiv heterosexual transmission probability quantum will provide direction for future research. Though lot is known about HIV, there are certain aspects which are yet to be understood. The factors responsible for serodiscordance i. Serodiscordance may also be explained in couples by the HIV negative individual's genetic makeup.
Sexual practices followed by the couple also influences sexual transmission. HIV negative individuals in discordant partnerships are at a high risk of infections and preventive interventions targeted at Hiv heterosexual transmission probability quantum individuals is the need of the Hiv Hiv heterosexual transmission probability quantum transmission probability quantum. This is an observational cross-sectional study design.
The partner reporting first was considered as index case. The mode Hiv heterosexual transmission probability quantum acquisition of HIV infection was ascertained from the history. The partner was counseled for examination and assessment of HIV status. Various factors like condom use, mode of transmission.
STI and circumcision were studied Hiv heterosexual transmission probability quantum their possible influence on spousal transmission was assessed. The details of marital life were enquired into. The data were collected on pre-tested questionnaires and later entered into a Microsoft excel spreadsheet. No identifying information was recorded on either hardcopy or the excel spreadsheet. Researchers had access to only excel spreadsheet which had no identifying information.
Data Hiv heterosexual transmission probability quantum analyzed using SAS software. Initially, frequencies of the variables were assessed and later cross tabulations against gender were Finally, factors affecting spousal transmission were analyzed. Power calculations were done instead of sample size due to limited number of discordant couples Evidence of STD in one of the spouses was observed in 6 couples out of 55 seroconcordant couples and 6 out of 36 serodiscordant couples.
Thus, out of 91 couples, one of the partners having STI was seen among 12 couples. The difference in the usage and the presence of STI among seroconcordant and serodiscordant couples was not statistically significant [ Table 2 ]. In present study, 11 Out of 91 couples, 72 couples were with the wife being HIV positive, and therefore had potential for vertical transmission.
Children of only 45 couples could be tested and 10 were positive. Heterosexual transmission
Hiv heterosexual responsible for Sixty percent Hiv heterosexual transmission probability quantum may be due to late testing in index case and non-adaptation of safe sex practices [ Table 1 ].
Hiv heterosexual transmission probability quantum probability quantum
Condom use was viewed only as a way Hiv heterosexual transmission probability quantum space births or to avoid illicit sexual activities, not as a health promotion measure. In a study in Rwanda, only More studies are required to study these factors responsible for low condom usage in marital sex in order to devise appropriate interventions to make use of condom as an effective preventive in Indian context.
While among discordant couples, non-usage of condoms poses higher chances of transmission to seronegative partner. Overall, 12 individuals had evidence of STIs [ Table 2 ]. Multiple studies have indicated at least a two-fold to five-fold increased risk for HIV infection among persons who have STIs, including genital ulcer diseases and non-ulcerative, inflammatory STIs. A retrospective cohort study of clients with repeat HIV tests attending a New Orleans STI clinic showed that recent syphilis or gonococci diagnosis was associated with significantly increased hazards of seroconversion among men: Hazard ratio [HR], 4.
A nested case-control study of initially HIVnegative women followed prospectively for a mean duration of 2 years showed that adjusted odds ratio for seroconversion were 4. A systematic review and meta-analysis by Weiss HA et al. Out of 91 couples
Hiv heterosexual transmission probability quantum the present study, children of only 45 couples were tested, of which 10 were HIV positive.
Hiv heterosexual transmission probability quantum couples try to conceive even after knowing their status because of the stigmata associated with not having children.
Problems faced by Hiv heterosexual transmission probability quantum positive female with a discordant partner is even greater, she has to take care of herself as well as the positive child along with bearing the stigmata. Adejuyigbe and Odebiyi in Nigeria studied on implications of parental serodiscordance on care of seropositive HIV child. Adaptation of permanent methods of sterilization and less acceptability of condoms among married couples, which are seen as mere contraceptive measures and not the modes of preventing sexually transmitted diseases, may be one of the
Hiv heterosexual transmission probability quantum responsible in transmission.
Further studies are needed to explore other risk factors like genetic makeup, associated with HIV transmission in discordant couples. There is a testing gap as far as children Hiv heterosexual transmission probability quantum seropositive mothers are concerned. Further studies are needed to explore risk factors like genetic makeup, viral load, innate immunity, sexual practices, and duration of exposure within intra-marital relationship, associated with HIV transmission in discordant couples.
We would also like to thank Dr.
Patricia Emmanuel and Sadaf Aslam for their valuable comments and suggestions. The content is solely the responsibility of the authors and does not necessarily represent the official
Hiv heterosexual transmission probability quantum of the Fogarty International Center or the National Institutes of Health.
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This article has been cited by other articles in PMC. Data management and analysis The data were collected on pre-tested questionnaires and later entered into a Microsoft excel spreadsheet. Table 1 Serostatus of spouse of index cases. Open in a separate window. Table 2 Variables associated with serostatus-condom use and presence of STIs. Table 3a Variables associated with serostatus-circumcision in HIV positive males index cases.
Table 3b Variables associated with serostatus circumcision in spouses of female index cases. Table 4 HIV status of children. Footnotes Source of Support: Characteristics of HIV-infected patients in concordant and discordant heterosexual relationships.
Hiv heterosexual transmission probability quantum among Hiv heterosexual transmission probability quantum married couples in India: Challenges for HIV prevention programs. Condom use among HIV seroconcordant positive couples: Assessment of sexually transmitted diseases as risk factors for HIV seroconversion in a new Orleans sexually transmitted disease clinic, Non-ulcerative sexually transmitted diseases as risk factors for HIV-1 transmission in women: Results from a cohort study.
A systematic review and meta analysis. Implications for the care of the HIV seropositive child in a resource-poor setting. Resistance to HIV-1 infection: Lessons learned from studies of highly exposed persistently seronegative Hiv heterosexual transmission probability quantum individuals.
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