title: Couples at risk for HIV infection in Southern India: characteristics of HIV-infected patients in concordant and discordant heterosexual relationships.
abstract: The aim of the article is to compare the clinical and behavioural characteristics of HIV-infected South Indian patients in concordant and discordant heterosexual relationships. A cross-sectional analysis of married couples in concordant and discordant relationships was carried out. Demographic and clinical characteristics, sexual behaviours, CD4 cell count and plasma HIV-1 RNA loads were assessed. A total of 839 concordant patients and 996 discordant patients were included in this analysis. Significantly more men were in discordant than concordant relationships (97% versus 59%; P = 0.002). More discordant patients had never initiated highly active antiretroviral treatment (HAART) than concordant patients (14.1% versus 8.5%; P = 0.004). Concordant patients had significantly higher CD4 cell counts than discordant patients at the time of enrolling to care (205 versus 139 cells/microL; P = 0.001). Discordant patients had significantly higher plasma viral loads than concordant patients (100,000 copies/mL versus 89,154 copies/mL; P = 0.002). Discordant patients were more likely to use condoms with their spouses than concordant patients (49% versus 28.8%; P = 0.01). In conclusion, couples-based interventions and the provision of HAART could substantially decrease behavioural and clinical correlates of HIV transmission among discordant South Indian married couples. The spouses of HIV-infected index patients are at increased risk for HIV infection, and further preventive measures are needed.
authors.affiliation: YRG Centre for AIDS Research and Education, Chennai, India. kumarasamy@yrgcare.org
authors.forename: N
authors.initials: N
authors.lastname: Kumarasamy
authors.forename: K K
authors.initials: KK
authors.lastname: Venkatesh
authors.forename: A K
authors.initials: AK
authors.lastname: Srikrishnan
authors.forename: L
authors.initials: L
authors.lastname: Prasad
authors.forename: P
authors.initials: P
authors.lastname: Balakrishnan
authors.forename: K G
authors.initials: KG
authors.lastname: Murugavel
authors.forename: E
authors.initials: E
authors.lastname: Thamburaj
authors.forename: S
authors.initials: S
authors.lastname: Solomon
authors.forename: K H
authors.initials: KH
authors.lastname: Mayer
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D005191:Family Characteristics; D005260:Female; D015658:HIV Infections / Q000276:immunology / Q000523:psychology* / Q000821:virology; D015497:HIV-1; D020010:Heterosexuality; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents