Sexually transmitted infections among HIV-1-discordant couples

• Published in: PloS one Vol. 4; no. 12; p. e8276
• Main Authors: Guthrie, Brandon L, Kiarie, James N, Morrison, Susan, John-Stewart, Grace C, Kinuthia, John, Whittington, William L H, Farquhar, Carey
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 14.12.2009; Public Library of Science (PLoS)
• Subjects: Acquired immune deficiency syndrome; Adult; AIDS; Biological effects; Chlamydia; Correlation; Counseling; Couples; Demography; Discordance; Disease transmission; Epidemics; Epidemiology; Female; Females; Gonorrhea; Gynecology; Health aspects; Health risks; Herpes viruses; Herpesvirus 2, Human - physiology; HIV; HIV Infections - complications; HIV Infections - transmission; HIV Infections - virology; HIV-1 - physiology; Human immunodeficiency virus; Human immunodeficiency virus 1; Humans; Husband-wife relations; Infections; Infectious Diseases/Epidemiology and Control of Infectious Diseases; Infectious Diseases/HIV Infection and AIDS; Infectious Diseases/Sexually Transmitted Diseases; Laboratories; Male; Males; Medicine; Mens health; Obstetrics; Prevalence; Prevention; Public Health and Epidemiology/Epidemiology; Public Health and Epidemiology/Infectious Diseases; Sexual Behavior; Sexual Partners; Sexually transmitted disease prevention; Sexually transmitted diseases; Sexually Transmitted Diseases - complications; Sexually Transmitted Diseases - epidemiology; STD; Syphilis; Treponema pallidum; Trichomoniasis; United States > US
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0008276

More new HIV-1 infections occur within stable HIV-1-discordant couples than in any other group in Africa, and sexually transmitted infections (STIs) may increase transmission risk among discordant couples, accounting for a large proportion of new HIV-1 infections. Understanding correlates of STIs among discordant couples will aid in optimizing interventions to prevent HIV-1 transmission in these couples. HIV-1-discordant couples in which HIV-1-infected partners were HSV-2-seropositive were tested for syphilis, chlamydia, gonorrhea, and trichomoniasis, and HIV-1-uninfected partners were tested for HSV-2. We assessed sociodemographic, behavioral, and biological correlates of a current STI. Of 416 couples enrolled, 16% were affected by a treatable STI, and among these both partners were infected in 17% of couples. A treatable STI was found in 46 (11%) females and 30 (7%) males. The most prevalent infections were trichomoniasis (5.9%) and syphilis (2.6%). Participants were 5.9-fold more likely to have an STI if their partner had an STI (P<0.01), and STIs were more common among those reporting any unprotected sex (OR = 2.43; P<0.01) and those with low education (OR = 3.00; P<0.01). Among HIV-1-uninfected participants with an HSV-2-seropositive partner, females were significantly more likely to be HSV-2-seropositive than males (78% versus 50%, P<0.01). Treatable STIs were common among HIV-1-discordant couples and the majority of couples affected by an STI were discordant for the STI, with relatively high HSV-2 discordance. Awareness of STI correlates and treatment of both partners may reduce HIV-1 transmission. ClinicalTrials.gov NCT00194519.