HIV sero-discordance among married HIV patients initiating anti-retroviral therapy in northern Vietnam
Identifieur interne : 003B64 ( Ncbi/Merge ); précédent : 003B63; suivant : 003B65HIV sero-discordance among married HIV patients initiating anti-retroviral therapy in northern Vietnam
Auteurs : Vu Van Tam [Suède] ; Do Duy Cuong [Suède] ; Tobias Alfven [Suède] ; Ho Dang Phuc [Viêt Nam] ; Nguyen Thi Kim Chuc [Viêt Nam] ; Nguyen Phuong Hoa [Viêt Nam] ; Vinod Diwan [Suède] ; Mattias Larsson [Suède, Viêt Nam]Source :
- AIDS Research and Therapy [ 1742-6405 ] ; 2016.
Abstract
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.
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.
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.
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.
Url:
DOI: 10.1186/s12981-016-0124-9
PubMed: 27891160
PubMed Central: 5109648
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sortKey="Larsson, Mattias" sort="Larsson, Mattias" uniqKey="Larsson M" first="Mattias" last="Larsson">Mattias Larsson</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Division of Global Health, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Division of Global Health, Department of Public Health Sciences, Karolinska Institute, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff3">Oxford University Clinical Research Unit, Ha Noi, Vietnam</nlm:aff><country xml:lang="fr">Viêt Nam</country><wicri:regionArea>Oxford University Clinical Research Unit, Ha Noi</wicri:regionArea><wicri:noRegion>Ha Noi</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27891160</idno><idno 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Tam</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Division of Global Health, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Division of Global Health, Department of Public Health Sciences, Karolinska Institute, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Cuong, Do Duy" sort="Cuong, Do Duy" uniqKey="Cuong D" first="Do Duy" last="Cuong">Do Duy Cuong</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Division of Global Health, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Division of Global Health, Department of Public Health Sciences, Karolinska Institute, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Alfven, Tobias" sort="Alfven, Tobias" uniqKey="Alfven T" first="Tobias" last="Alfven">Tobias Alfven</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Division of Global Health, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Division of Global Health, Department of Public Health Sciences, Karolinska Institute, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Phuc, Ho Dang" sort="Phuc, Ho Dang" uniqKey="Phuc H" first="Ho Dang" last="Phuc">Ho Dang Phuc</name><affiliation wicri:level="1"><nlm:aff id="Aff4">Department of Probability and Mathematical Statistics, Institute of Mathematics, Ha Noi, Vietnam</nlm:aff><country xml:lang="fr">Viêt Nam</country><wicri:regionArea>Department of Probability and Mathematical Statistics, Institute of Mathematics, Ha Noi</wicri:regionArea><wicri:noRegion>Ha Noi</wicri:noRegion></affiliation></author><author><name sortKey="Chuc, Nguyen Thi Kim" sort="Chuc, Nguyen Thi Kim" uniqKey="Chuc N" first="Nguyen Thi Kim" last="Chuc">Nguyen Thi Kim Chuc</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Health System Research Project, Ha Noi Medical University, Ha Noi, Vietnam</nlm:aff><country xml:lang="fr">Viêt Nam</country><wicri:regionArea>Health System Research Project, Ha Noi Medical University, Ha Noi</wicri:regionArea><wicri:noRegion>Ha Noi</wicri:noRegion></affiliation></author><author><name sortKey="Hoa, Nguyen Phuong" sort="Hoa, Nguyen Phuong" uniqKey="Hoa N" first="Nguyen Phuong" last="Hoa">Nguyen Phuong Hoa</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Health System Research Project, Ha Noi Medical University, Ha Noi, Vietnam</nlm:aff><country xml:lang="fr">Viêt Nam</country><wicri:regionArea>Health System Research Project, Ha Noi Medical University, Ha Noi</wicri:regionArea><wicri:noRegion>Ha Noi</wicri:noRegion></affiliation></author><author><name sortKey="Diwan, Vinod" sort="Diwan, Vinod" uniqKey="Diwan V" first="Vinod" last="Diwan">Vinod Diwan</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Division of Global Health, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Division of Global Health, Department of Public Health Sciences, Karolinska Institute, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Larsson, Mattias" sort="Larsson, Mattias" uniqKey="Larsson M" first="Mattias" last="Larsson">Mattias Larsson</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Division of Global Health, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Division of Global Health, Department of Public Health Sciences, Karolinska Institute, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff3">Oxford University Clinical Research Unit, Ha Noi, Vietnam</nlm:aff><country xml:lang="fr">Viêt Nam</country><wicri:regionArea>Oxford University Clinical Research Unit, Ha Noi</wicri:regionArea><wicri:noRegion>Ha Noi</wicri:noRegion></affiliation></author></analytic><series><title level="j">AIDS Research and Therapy</title><idno type="eISSN">1742-6405</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>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.</p></sec><sec><title>Methods</title><p>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.</p></sec><sec><title>Results</title><p>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.</p></sec><sec><title>Conclusion</title><p>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.</p><p><italic>Trial registration</italic> NCT01433601</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Labbett, W" uniqKey="Labbett W">W Labbett</name></author><author><name sortKey="Garcia Diaz, A" uniqKey="Garcia Diaz A">A Garcia-Diaz</name></author><author><name sortKey="Fox, Z" uniqKey="Fox Z">Z Fox</name></author><author><name sortKey="Clewley, Gs" uniqKey="Clewley G">GS Clewley</name></author><author><name sortKey="Fernandez, T" uniqKey="Fernandez T">T Fernandez</name></author><author><name sortKey="Johnson, M" uniqKey="Johnson M">M Johnson</name></author><author><name sortKey="Geretti, Am" uniqKey="Geretti A">AM 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<front><journal-meta><journal-id journal-id-type="nlm-ta">AIDS Res Ther</journal-id><journal-id journal-id-type="iso-abbrev">AIDS Res Ther</journal-id><journal-title-group><journal-title>AIDS Research and Therapy</journal-title></journal-title-group><issn pub-type="epub">1742-6405</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27891160</article-id><article-id pub-id-type="pmc">5109648</article-id><article-id pub-id-type="publisher-id">124</article-id><article-id pub-id-type="doi">10.1186/s12981-016-0124-9</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research</subject></subj-group></article-categories><title-group><article-title>HIV sero-discordance among married HIV patients initiating anti-retroviral therapy in northern Vietnam</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Van Tam</surname><given-names>Vu</given-names></name><address><email>tamvanvu@yahoo.com</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Cuong</surname><given-names>Do Duy</given-names></name><address><email>doduy.cuong@gmail.com</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Alfven</surname><given-names>Tobias</given-names></name><address><email>tobias.alfven@ki.se</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Phuc</surname><given-names>Ho Dang</given-names></name><address><email>hodang54@yahoo.com</email></address><xref ref-type="aff" rid="Aff4">4</xref></contrib><contrib contrib-type="author"><name><surname>Chuc</surname><given-names>Nguyen Thi Kim</given-names></name><address><email>chuc.ntk@gmail.com</email></address><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Hoa</surname><given-names>Nguyen Phuong</given-names></name><address><email>hoatuber@yahoo.com</email></address><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Diwan</surname><given-names>Vinod</given-names></name><address><email>vinod.diwan@ki.se</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0002-0514-7445</contrib-id><name><surname>Larsson</surname><given-names>Mattias</given-names></name><address><email>mattias.larsson@ki.se</email></address><xref ref-type="aff" rid="Aff1">1</xref><xref ref-type="aff" rid="Aff3">3</xref></contrib><aff id="Aff1"><label>1</label>Division of Global Health, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden</aff><aff id="Aff2"><label>2</label>Health System Research Project, Ha Noi Medical University, Ha Noi, Vietnam</aff><aff id="Aff3"><label>3</label>Oxford University Clinical Research Unit, Ha Noi, Vietnam</aff><aff id="Aff4"><label>4</label>Department of Probability and Mathematical Statistics, Institute of Mathematics, Ha Noi, Vietnam</aff></contrib-group><pub-date pub-type="epub"><day>15</day><month>11</month><year>2016</year></pub-date><pub-date pub-type="pmc-release"><day>15</day><month>11</month><year>2016</year></pub-date><pub-date pub-type="collection"><year>2016</year></pub-date><volume>13</volume><elocation-id>39</elocation-id><history><date date-type="received"><day>7</day><month>6</month><year>2016</year></date><date date-type="accepted"><day>1</day><month>11</month><year>2016</year></date></history><permissions><copyright-statement>© The Author(s) 2016</copyright-statement><license license-type="OpenAccess"><license-p><bold>Open Access</bold>This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><sec><title>Background</title><p>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.</p></sec><sec><title>Methods</title><p>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.</p></sec><sec><title>Results</title><p>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.</p></sec><sec><title>Conclusion</title><p>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.</p><p><italic>Trial registration</italic> NCT01433601</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>HIV</kwd><kwd>ART</kwd><kwd>Gender</kwd><kwd>Late presentation</kwd><kwd>Sero-discordance</kwd><kwd>Vietnam</kwd></kwd-group><funding-group><award-group><funding-source><institution>the Swedish International Development Cooperation Agency (Sida)</institution></funding-source><award-id>SWE2007404</award-id><principal-award-recipient><name><surname>Larsson</surname><given-names>Mattias</given-names></name></principal-award-recipient></award-group></funding-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2016</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc><affiliations><list><country><li>Suède</li><li>Viêt Nam</li></country><region><li>Svealand</li></region><settlement><li>Stockholm</li></settlement></list><tree><country name="Suède"><region name="Svealand"><name sortKey="Van Tam, Vu" sort="Van Tam, Vu" uniqKey="Van Tam V" first="Vu" last="Van Tam">Vu Van Tam</name></region><name sortKey="Alfven, Tobias" sort="Alfven, Tobias" uniqKey="Alfven T" first="Tobias" last="Alfven">Tobias Alfven</name><name sortKey="Cuong, Do Duy" sort="Cuong, Do Duy" uniqKey="Cuong D" first="Do Duy" last="Cuong">Do Duy Cuong</name><name sortKey="Diwan, Vinod" sort="Diwan, Vinod" uniqKey="Diwan V" first="Vinod" last="Diwan">Vinod Diwan</name><name sortKey="Larsson, Mattias" sort="Larsson, Mattias" uniqKey="Larsson M" first="Mattias" last="Larsson">Mattias Larsson</name></country><country name="Viêt Nam"><noRegion><name sortKey="Phuc, Ho Dang" sort="Phuc, Ho Dang" uniqKey="Phuc H" first="Ho Dang" last="Phuc">Ho Dang Phuc</name></noRegion><name sortKey="Chuc, Nguyen Thi Kim" sort="Chuc, Nguyen Thi Kim" uniqKey="Chuc N" first="Nguyen Thi Kim" last="Chuc">Nguyen Thi Kim Chuc</name><name sortKey="Hoa, Nguyen Phuong" sort="Hoa, Nguyen Phuong" uniqKey="Hoa N" first="Nguyen Phuong" last="Hoa">Nguyen Phuong Hoa</name><name sortKey="Larsson, Mattias" sort="Larsson, Mattias" uniqKey="Larsson M" first="Mattias" last="Larsson">Mattias Larsson</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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