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HIV sero-discordance among married HIV patients initiating anti-retroviral therapy in northern Vietnam
Authors:Vu?Van?Tam  author-information"  >  author-information__contact u-icon-before"  >  mailto:tamvanvu@yahoo.com"   title="  tamvanvu@yahoo.com"   itemprop="  email"   data-track="  click"   data-track-action="  Email author"   data-track-label="  "  >Email author,Do?Duy?Cuong,Tobias?Alfven,Ho?Dang?Phuc,Nguyen?Thi?Kim?Chuc,Nguyen?Phuong?Hoa,Vinod?Diwan,Mattias?Larsson  author-information"  >  author-information__orcid u-icon-before icon--orcid u-icon-no-repeat"  >  http://orcid.org/---"   itemprop="  url"   title="  View OrcID profile"   target="  _blank"   rel="  noopener"   data-track="  click"   data-track-action="  OrcID"   data-track-label="  "  >View author&#  s OrcID profile
Affiliation:1.Division of Global Health, Department of Public Health Sciences,Karolinska Institute,Stockholm,Sweden;2.Health System Research Project,Ha Noi Medical University,Ha Noi,Vietnam;3.Oxford University Clinical Research Unit,Ha Noi,Vietnam;4.Department of Probability and Mathematical Statistics,Institute of Mathematics,Ha Noi,Vietnam
Abstract:

Background

In many countries in Asia, the HIV epidemic is in a concentrated phase, with high prevalence in certain risk groups, such as men who inject drugs. There is also a rapid increase of HIV among women. The latter might be due to high levels of sero-discordant couples and increasing transmission from male to female partners over time.

Methods

All adult married patients initiating antiretroviral treatment at four out-patient clinics in Quang Ninh province in north-eastern Vietnam between 2007 and 2009 were asked to participate in the study. Clinical information was extracted from patients’ records, and a structured questionnaire was used to collect social, demographic and economic data.

Results

Two hundred eighty-eight married patients for whom information on the HIV status of their spouse was available were included in the study. Overall, the sero-discordance rate was 58%. The sero-discordance rate was significantly higher among married males, 71% had spouses not infected, than married females, of whom 18% had spouses not infected. Other factors associated with a high rate of sero-discordance were injection drug use (IDU) history, tuberculosis (TB) history and the availability of voluntary counselling and testing (VCT) in residential locations. High sero-concordance was associated with college/university education.

Conclusion

The sero-discordance was significantly higher among married males than married females. Other factors also related to high sero-discordance were history of IDU, history of TB and the availability of VCT in residential locations. In contrast, college/university education and female sex were significantly related to low sero-discordance. To contain the increasing HIV prevalence among women, measures should be taken to prevent transmission among sero-discordant couples. Trial registration NCT01433601
Keywords:
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