The Human Immunodeficiency Virus (HIV) remains a major global public health challenge. By 2022, there were nearly 39.9 million people globally living with HIV, 53% are women and girls. Serodiscordant couples, a couple with one partner positive for HIV, play a critical role in HIV transmission. This is particularly evident in sub-Saharan Africa, where up to 10.90% of couples are serodiscordant, making them a key population for targeted prevention efforts. This study aimed to determine the impact of viral load, antiretroviral therapy (ART) adherence and the behavioral pattern of serodiscordant couple likely to influence HIV transmission. A prospective study was carried out and concerned HIV-1 serodiscordant couples. Parameters such as age, frequency of HIV testing, duration of relationship, number of children, social status, and educational level of partners were analyzed. Questionnaires were used to assess emotional support, communication, and HIV knowledge. Adherence to ART was assessed by pill counting and self-report. Plasma viral load of HIV-positive partners was measured using the GeneXpert platform. Thirty-four (34) HIV-1 serodiscordant couples were included in our study. Women (HIV negative) had an average age of 33 ± 2.21, while the HIV-negative men had an average age of 40.63 ± 1.73. The frequency of HIV testing was 1.60 times/year for women and 2.15 times/year for men. Analysis of viral load showed that, 91.2% of HIV-positive partners had an undetectable viral load, with adherence to ART observed in 91.2%. Open communication and emotional support were present in 88.2% and 72.4% of partners respectively. Our results suggest that HIV non-transmission in these couples is influenced by both treatment adherence which contributed to viral load suppression and positive interpersonal relationships. Emotional support and open communication are key factors that could contribute to preserving the health of serodiscordant couples.
References
[1]
UNAIDS (2024) Fact Sheet 2024—Latest Global and Regional HIV Statistics on the Status of the AIDS Epidemic.
[2]
OMS Tchad (2023) Rapport biennal Santé pour Tous: Engagements et Réalisations Tchad.
[3]
Chihana, M.L., Conan, N., Ellman, T., Poulet, E., Garone, D.B., Ortuno, R., et al. (2021) The HIV Cascade of Care among Serodiscordant Couples in Four High HIV Prevalence Settings in Sub-Saharan Africa. SouthAfricanMedicalJournal, 111, 768-776. https://doi.org/10.7196/samj.2021.v111i8.15489
[4]
Eyawo, O., de Walque, D., Ford, N., Gakii, G., Lester, R.T. and Mills, E.J. (2010) HIV Status in Discordant Couples in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. TheLancetInfectiousDiseases, 10, 770-777. https://doi.org/10.1016/s1473-3099(10)70189-4
[5]
Cohen, M.S., Gamble, T. and McCauley, M. (2020) Prevention of HIV Transmission and the HPTN 052 Study. AnnualReviewofMedicine, 71, 347-360. https://doi.org/10.1146/annurev-med-110918-034551
[6]
Desgrées-du-Loû, A. and Orne-Gliemann, J. (2008) Couple-Centred Testing and Counselling for HIV Serodiscordant Heterosexual Couples in Sub-Saharan Africa. ReproductiveHealthMatters, 16, 151-161. https://doi.org/10.1016/s0968-8080(08)32407-0
[7]
Thigpen, M.C., Kebaabetswe, P.M., Paxton, L.A., Smith, D.K., Rose, C.E., Segolodi, T.M., et al. (2012) Antiretroviral Preexposure Prophylaxis for Heterosexual HIV Transmission in Botswana. NewEnglandJournalofMedicine, 367, 423-434. https://doi.org/10.1056/nejmoa1110711
[8]
Burton, J., Darbes, L.A. and Operario, D. (2008) Couples-Focused Behavioral Interventions for Prevention of HIV: Systematic Review of the State of Evidence. AIDSandBehavior, 14, 1-10. https://doi.org/10.1007/s10461-008-9471-4
[9]
MSPP (2022) Plan National de Development Sanitaire (PNDS).
[10]
Gerbi, G.B., Habtemariam, T., Robnett, V., Nganwa, D. and Tameru, B. (2012) Psychosocial Factors as Predictors of HIV/AIDS Risky Behaviors among People Living with HIV/AIDS. Journal of AIDS and HIV Research, 4, 8-16.
[11]
Soubeiga, S.T., Compaoré, R., Djigma, F., Zagre, N., Assengone, E., Traoré, L., et al. (2015) Evaluation du traitement antirétroviral chez les femmes enceintes VIH-1 positif, sur la transmission de l’infection de la mère à l’enfant: Cas du Centre Médical Saint Camille de Ouagadougou, au Burkina Faso. PanAfricanMedicalJournal, 20, Article 399. https://doi.org/10.11604/pamj.2015.20.399.5627
[12]
Roxby, A.C., Ben-Youssef, L., Marx, G., Kinoti, F., Bosire, R., Guthrie, B., et al. (2016) Dual Contraceptive Method Use in HIV-Serodiscordant Kenyan Couples. JournalofFamilyPlanningandReproductiveHealthCare, 42, 264-270. https://doi.org/10.1136/jfprhc-2015-101233
[13]
Bavinton, B.R., Jin, F., Prestage, G., Zablotska, I., Koelsch, K.K., Phanuphak, N., et al. (2014) The Opposites Attract Study of Viral Load, HIV Treatment and HIV Transmission in Serodiscordant Homosexual Male Couples: Design and Methods. BMCPublicHealth, 14, Article No. 917. https://doi.org/10.1186/1471-2458-14-917
[14]
Mashaphu, S., Wyatt, G.E., Gomo, E. and Tomita, A. (2018) Intimate Partner Violence among HIV-Serodiscordant Couples in Durban, South Africa. SouthAfricanMedicalJournal, 108, 960-964. https://doi.org/10.7196/samj.2018.v108i11.13095
[15]
Lelaka, C.M., Moyo, I., Tshivhase, L. and Mavhandu-Mudzusi, A.H. (2022) Psychosocial Support for HIV Serodiscordant Couples. HealthPsychologyandBehavioralMedicine, 10, 537-556. https://doi.org/10.1080/21642850.2022.2084098
[16]
King, R., Wamai, N., Khana, K., Johansson, E., Lindkvist, P. and Bunnell, R. (2012) “maybe His Blood Is Still Strong”: A Qualitative Study among HIV-Sero-Discordant Couples on ART in Rural Uganda. BMCPublicHealth, 12, Article No. 801. https://doi.org/10.1186/1471-2458-12-801
[17]
Reynolds, S.J., Makumbi, F., Nakigozi, G., Kagaayi, J., Gray, R.H., Wawer, M., et al. (2011) HIV-1 Transmission among HIV-1 Discordant Couples before and after the Introduction of Antiretroviral Therapy. AIDS, 25, 473-477. https://doi.org/10.1097/qad.0b013e3283437c2b
[18]
Cohen, M.S., Chen, Y.Q., McCauley, M., Gamble, T., Hosseinipour, M.C., Kumarasamy, N., et al. (2011) Prevention of HIV-1 Infection with Early Antiretroviral Therapy. NewEnglandJournalofMedicine, 365, 493-505. https://doi.org/10.1056/nejmoa1105243
[19]
Tchakounté, C., Nkenfou, C.N., Tchouangueu, T.F., Ngoufack,, N.M., Tchuandom, S.B., Ngono, O.D., et al. (2020) HIV Serodiscordance among Couples in Cameroon: Effects on Sexual and Reproductive Health. InternationalJournalofMaternalandChildHealthandAIDS (IJMA), 9, 330-336. https://doi.org/10.21106/ijma.370
[20]
Tadesse, M. (2014) Assessment of HIV Discordance and Associated Risk Factors among Couples Receiving HIV Test in Dilla, Ethiopia. BMCResearchNotes, 7, Article No. 893. https://doi.org/10.1186/1756-0500-7-893
[21]
Yasin, I. (2023) Occurrence and Factors Associated with HIV-Sero-Discordance in Couples at Iganga General Hospital-Iganga District, Eastern Uganda. IDOSRJournalofExperimentalSciences, 9, 17-28. https://doi.org/10.59298/idosr/jes/101.1.7002
[22]
Rodger, A.J., Cambiano, V., Bruun, T., Vernazza, P., Collins, S., Degen, O., et al. (2019) Risk of HIV Transmission through Condomless Sex in Serodifferent Gay Couples with the HIV-Positive Partner Taking Suppressive Antiretroviral Therapy (PARTNER): Final Results of a Multicentre, Prospective, Observational Study. TheLancet, 393, 2428-2438. https://doi.org/10.1016/s0140-6736(19)30418-0
[23]
Gandhi, R.T., Bedimo, R., Hoy, J.F., Landovitz, R.J., Smith, D.M., Eaton, E.F., et al. (2023) Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults: 2022 Recommendations of the International Antiviral Society-USA Panel. JAMA, 329, 63-84. https://doi.org/10.1001/jama.2022.22246
[24]
Essomba, E.N., Adiogo, D., Kedy, D.C., Amang, B., Lehman, L.G. and Coppieters, Y. (2015) Facteurs associés à la non observance thérapeutique des sujets adultes infectés par le VIH sous antirétroviraux dans un hôpital de référence à Douala. PanAfricanMedicalJournal, 20, Article 412. https://doi.org/10.11604/pamj.2015.20.412.5678