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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Regional differences in prevalence of HIV-1 discordance in Africa and enrollment of HIV-1 discordant couples into an HIV-1 prevention trial
PLoS ONE, Volume 3, No. 1, Article e1411, Year 2008
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Description
Background. Most HIV-1 transmission in Africa occurs among HIV-1-discordant couples (one partner HIV-1 infected and one uninfected) who are unaware of their discordant HIV-1 serostatus. Given the high HIV-1 incidence among HIV-1 discordant couples and to assess efficacy of interventions for reducing HIV-1 transmission, HIV-1 discordant couples represent a critical target population for HIV-1 prevention interventions and prevention trials. Substantial regional differences exist in HIV-1 prevalence in Africa, but regignal differences in HIV-1 discordance among African couples, has not previously been reported. Methodology & Principal Findings. The Partners in Prevention HSV-2/ HIV-1 Transmission Trial ("Partners HSV-2 Study"), the first large HIV-1 prevention trial in Africa involving HIV-1 discordant couples, completed enrollment in May 200). Partners HSV-2 Study recruitment data from 12 sites from East and Southern Africa were used to assess HIV-1 discordance among couples accessing couples HIV-1 counseling and testing, and to correlate with enrollment of HIV-1 discordant couples. HIV-1 discordance at Partners HSV-2 Study sites ranged from 8-31% of couples tested from the community. Across all study sites and, among all couples with one HIV-1 infected partner, almost half (49%) of couples were HIV-1 discordant. Site-specific monthly enrollment of HIV-1 discordant couples into the clinical trial was not directly associated with prevalence of HIV-1 discordance, but was modestly correlated with national HIV-1 counseling and testing rates and access to palliative care/basic health care (r=0.74, p=0.09). Conclusions/Significance. HIV-1 discordant couples are a critical target for HIV-1 prevention in Africa. In addition to community prevalence of HIV-1 discordance, national infrastructure for HIV-1 testing and healthcare delivery and effective community outreach strategies impact recruitment of HIV-1 discordant couples into HIV-1 prevention trials. © 2008 Lingappa et al.
Authors & Co-Authors
Lingappa, Jairam R.
United States, Seattle
University of Washington
Lambdin, Barrot Hopkins
United States, Seattle
University of Washington
Bukusi, Elizabeth Anne
Kenya, Nairobi
Kenya Medical Research Institute
Ngure, Kenneth K.
Kenya, Nairobi
Kenyatta National Hospital
Kavuma, Linda
Uganda, Kampala
School of Medicine, Makerere University College of Health Sciences
Inambao, Mubiana
Zambia, Ndola
Rwanda Zambia Hiv Research Group
Kanweka, William
Zambia, Ndola
Rwanda Zambia Hiv Research Group
Allen, Susan A.
United States, Atlanta
Rollins School of Public Health
Kiarie, James Njogu
Kenya, Nairobi
University of Nairobi
Makhema, Joseph M.
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
Were, Edwin O.
Kenya, Eldoret
Moi University
Manongi, Rachel N.
Tanzania, Moshi
Kilimanjaro Christian Medical Centre
Coetzee, David John
South Africa, Cape Town
University of Cape Town
De Bruyn, Guy
South Africa, Johannesburg
University of the Witwatersrand
Delany-Moretlwe, Sinead
South Africa, Johannesburg
University of the Witwatersrand
Magaret, Amalia Meier
United States, Seattle
University of Washington
Mugo, Nelly Rwamba
United States, Seattle
University of Washington
Kenya, Nairobi
Kenyatta National Hospital
Mujugira, Andrew
United States, Seattle
University of Washington
Ndase, Patrick
United States, Seattle
University of Washington
Celum, Connie L.
United States, Seattle
University of Washington
Cohen, Craig R.
United States, San Francisco
University of California, San Francisco
Farquhar, Carey
United States, Seattle
University of Washington
John-Stewart, Grace C.
United States, Seattle
University of Washington
Katabira, Elly Tebasoboke
Uganda, Kampala
School of Medicine, Makerere University College of Health Sciences
Ronald, Allan R.
Canada, Winnipeg
University of Manitoba
Essex, Max E.
United States, Cambridge
Harvard University
Fife, Kenneth H.
United States, Bloomington
Indiana University Bloomington
Kapiga, Saidi Hussein
United States, Cambridge
Harvard University
deKock, Alana
South Africa, Cape Town
University of Cape Town
Gray, Glenda E.
South Africa, Johannesburg
University of the Witwatersrand
McIntyre, James Alasdair
South Africa, Johannesburg
University of the Witwatersrand
Rees, Helen V.
South Africa, Johannesburg
University of the Witwatersrand
Statistics
Citations: 179
Authors: 32
Affiliations: 16
Identifiers
Doi:
10.1371/journal.pone.0001411
e-ISSN:
19326203
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study