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Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model
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HIV status in discordant couples in sub-Saharan Africa: a systematic review and meta-analysis

Oghenowede Eyawo1, Damien de Walque, Nathan Ford

  • 1Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada.

The Lancet. Infectious Diseases
|October 8, 2010
PubMed

Insights

In HIV-affected couples in sub-Saharan Africa, women are as likely as men to be the first infected partner. Prevention strategies must equally target both sexes to reduce HIV transmission.

Area of Science:

  • Public Health
  • Epidemiology
  • Infectious Diseases

Background:

  • Sub-Saharan Africa has many HIV-affected couples in serodiscordant relationships.
  • Current HIV/AIDS campaigns often focus on men as the primary source of infection.
  • This study examines the gender distribution of index-case infections in stable HIV-discordant relationships.

Purpose of the Study:

  • To determine the gender balance of index-case infections in heterosexual HIV-discordant couples.
  • To inform HIV prevention strategies by understanding who is more likely to be the first infected partner.

Main Methods:

  • Systematic review and random-effects meta-analysis of 27 cohorts (13,061 couples).
  • Meta-regression analysis incorporating data from Demographic and Health Surveys (DHS) in 14 countries (1,145 couples).
  • Assessed the proportion of men and women who were the index case in serodiscordant relationships.

Main Results:

  • Women constituted 47% of index cases in HIV-discordant couples, indicating equal likelihood compared to men.
  • Demographic and Health Surveys data corroborated this finding (46%).
  • Factors associated with a higher proportion of female index cases included urban residence, higher latitude, lower gender equality, higher HIV prevalence, and older age.

Conclusions:

  • HIV prevention efforts, including condom promotion and risk behavior mitigation, should equally target both men and women.
  • Understanding the gender dynamics of index infections is crucial for effective HIV/AIDS control in sub-Saharan Africa.
Abstract

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