HIV transmission and related risk factors among serodiscordant couples in Liuzhou, China

Abstract

To evaluate the incidence and risk factors for human immunodeficiency virus (HIV) seroconversion of HIV-negative partners among HIV-discordant couples in Liuzhou, China, 1854 eligible HIV-serodiscordant couples were retrospectively identified through the HIV epidemiology and follow-up database from January 1, 1996 to June 30, 2013. Cox proportional-hazards model was used to examine risk factors related to HIV seroconversion of negative partners. Finally, 125 HIV seroconversion occurred over 4963.5 person-years, resulting in an overall HIV incidence of 2.52/100 person-years. HIV-positive partners with the last CD4 counts of 350 cells/ul or more were significantly protected against HIV seroconversion compared with those CD4 counts of less than 200 cells/ul (aHR = 0.46, 95% CI: 0.27-0.81, P < 0.01). Men with HIV-positive wives (aHR: 1.96, 95% CI: 1.27-3.02, P < 0.01), HIV-positive partners who did not receive ART before their HIV-negative partners' seroconversion (aHR: 2.22, 95% CI, 1.41-3.51, P < 0.01) and patients reported intermittent condom use (aHR: 7.60, 95% CI, 4.37-13.21, P < 0.01) were associated with increased risk of HIV seroconversion. HIV-negative partners remain high risk of HIV infection in Liuzhou city. Comprehensive package of HIV prevention services should contribute to reduction in HIV transmission of discordant couples.

Sex differences in the incidence and clearance of anal human papillomavirus infection among heterosexual men and women in Liuzhou, China: An observational cohort study

“…Carcinogenic HPV persistent infection is the most important reason for the progression of HPV-related anogenital cancers. 23 Therefore, the sex difference in the incidence of anal cancer in Liuzhou could not represent the overall sex trend of China and might be more similar to sexually active trends in developed countries in which women have higher incidences of anal caner than men. 22 Our data indicated that HPV 16 infections were more persistent in females than in males.…”

“…17 Zhang et al reported that the HIV incidence among HIV-discordant couples of Liuzhou city is higher than the national level. 23 Therefore, the sex difference in the incidence of anal cancer in Liuzhou could not represent the overall sex trend of China and might be more similar to sexually active trends in developed countries in which women have higher incidences of anal caner than men. 24,25 Because few anal cancer cases were reported each year in Liuzhou, we could not sufficiently directly analyze the difference in incidences between sexes.…”

Willingness to use HIV pre-exposure prophylaxis and associated factors among men who have sex with men in Liuzhou, China

“…Liuzhou is a city with the highest prevalence of HIV infection in Guangxi Zhuang Autonomous Region which has the second-largest number of people living with HIV in south central China (17). And MSM ranked the second place among the number of newly identi ed HIV/AIDS cases in Liuzhou city (18).…”

Assortative mixing as a source of bias in epidemiological studies of sexually transmitted infections: the case of smoking and human papillomavirus

“…To control for differences in exposure to infection, studies have restricted their population to individuals known to have been exposed to infection. For instance, studies examining risk factors of HIV transmission have used populations of serodiscordant couples [38, 39], where the uninfected partner is known to be exposed. However, such studies are rarely performed for other STIs, as they are costly and methodologically challenging (difficult to adequately condition on exposure to infection).…”