Regional differences in prevalence of HIV-1 discordance in Africa and enrollment of HIV-1 discordant couples into an HIV-1 prevention trial

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dc.contributor.authorLingappa, Jairam Ren_ZA
dc.contributor.authorLambdin, Barroten_ZA
dc.contributor.authorBukusi, Elizabeth Annen_ZA
dc.contributor.authorNgure, Kennethen_ZA
dc.contributor.authorKavuma, Lindaen_ZA
dc.contributor.authorInambao, Mubianaen_ZA
dc.contributor.authorKanweka, Williamen_ZA
dc.contributor.authorAllen, Susanen_ZA
dc.contributor.authorKiarie, James Nen_ZA
dc.contributor.authorMakhema, Josephen_ZA
dc.date.accessioned2016-01-02T05:05:40Z
dc.date.available2016-01-02T05:05:40Z
dc.date.issued2008en_ZA
dc.description.abstractBACKGROUND: 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 regional 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 2007. 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.en_ZA
dc.identifier.apacitationLingappa, J. R., Lambdin, B., Bukusi, E. A., Ngure, K., Kavuma, L., Inambao, M., ... Makhema, J. (2008). Regional differences in prevalence of HIV-1 discordance in Africa and enrollment of HIV-1 discordant couples into an HIV-1 prevention trial. <i>PLoS One</i>, http://hdl.handle.net/11427/16151en_ZA
dc.identifier.chicagocitationLingappa, Jairam R, Barrot Lambdin, Elizabeth Ann Bukusi, Kenneth Ngure, Linda Kavuma, Mubiana Inambao, William Kanweka, Susan Allen, James N Kiarie, and Joseph Makhema "Regional differences in prevalence of HIV-1 discordance in Africa and enrollment of HIV-1 discordant couples into an HIV-1 prevention trial." <i>PLoS One</i> (2008) http://hdl.handle.net/11427/16151en_ZA
dc.identifier.citationLingappa, J. R., Lambdin, B., Bukusi, E. A., Ngure, K., Kavuma, L., Inambao, M., ... & Were, E. (2008). 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, 3(1), e1411. doi:10.1371/journal.pone.0001411en_ZA
dc.identifier.ris TY - Journal Article AU - Lingappa, Jairam R AU - Lambdin, Barrot AU - Bukusi, Elizabeth Ann AU - Ngure, Kenneth AU - Kavuma, Linda AU - Inambao, Mubiana AU - Kanweka, William AU - Allen, Susan AU - Kiarie, James N AU - Makhema, Joseph AB - 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 regional 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 2007. 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. DA - 2008 DB - OpenUCT DO - 10.1371/journal.pone.0001411 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2008 T1 - Regional differences in prevalence of HIV-1 discordance in Africa and enrollment of HIV-1 discordant couples into an HIV-1 prevention trial TI - Regional differences in prevalence of HIV-1 discordance in Africa and enrollment of HIV-1 discordant couples into an HIV-1 prevention trial UR - http://hdl.handle.net/11427/16151 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/16151
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0001411
dc.identifier.vancouvercitationLingappa JR, Lambdin B, Bukusi EA, Ngure K, Kavuma L, Inambao M, et al. 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. 2008; http://hdl.handle.net/11427/16151.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentInstitute of Infectious Disease and Molecular Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2008 Lingappa et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherHIV-1en_ZA
dc.subject.otherAfricaen_ZA
dc.subject.otherZambiaen_ZA
dc.subject.otherPublic and occupational healthen_ZA
dc.subject.otherCircumcision for HIV preventionen_ZA
dc.subject.otherKenyaen_ZA
dc.subject.otherUgandaen_ZA
dc.subject.otherPalliative careen_ZA
dc.titleRegional differences in prevalence of HIV-1 discordance in Africa and enrollment of HIV-1 discordant couples into an HIV-1 prevention trialen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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