Email this article The prevalence and determinants of female serodiscordance among HIV positive pregnant women attending PMTCT clinic in Owerri, Imo state, Nigeria
Abstract
Background: Human Immunodeficiency Virus sero-discordance is high among heterosexual couples in Africa. However, only few studies have explored the factors that are associated with the prevalence in sub-Saharan Africa. The aim of this study was to determine the prevalence of female sero-discordance among HIV positive pregnant women in Owerri and to assess its possible associated factors.
Methods: A cross sectional study of pregnant women (and their partners) who tested positive to HIV I and II at the Prevention of Mother to Child Transmission (PMTCT) clinic from December 2015 to May 2016 in Federal Medical Center Owerri, Imo state, Nigeria.
Results: A total of 106 HIV positive pregnant women (and their partners) were studied. The prevalence of female serodiscordance was 63.2% (67/106). Pre-marital serodiscordance contributed about 52.2% (35/67) female serodiscordance among couples in the study. Sero-discordance rate for the lower, middle, and upper classes were 50% (28/56), 76.1% (35/46) and 100% (4/4) respectively and was statistically significant (p<0.01). Condom use was significantly associated with female serodiscondance (P<0.01). CD4+ count of the female partner at booking was also found statistically significantly associated with female serodiscordance (P<0.01).
Conclusions: There is high prevalence of female serodiscordance among HIV positive pregnant women in Owerri. Pre-marital serodiscordance contributed significantly to high level of female serodiscordance among couples. Higher social class, condom use and high female- partner CD4+ count are significantly associated with female sero-discordance.
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Federal Ministry of Health. Fact Sheet: National HIV Sero-prevalence Sentinel Survey among Pregnant Women Attending Antenatal Clinics in Nigeria, 2015. Available at: http://nigeriahealthwatch.com/wp-content/uploads/bsk-pdf-manager/1176.
Dunkle KL, Stephenson R, Karita E, Chomba E, Kayitenkore K, Vwalika C, et al. New heterosexually transmitted HIV infections in married or cohabiting couples in urban Zambia and Rwanda: an analysis of survey and clinical data. Lancet. 2008;371(9631):2183-91.
Hugonnet S, Mosha F, Todd J, Mugeye K, Klokke A, Ndeki L, et al. Incidence of HIV infection in stable sexual partnerships: a retrospective cohort study of 1802 couples in Mwanza Region, Tanzania. J Acquire Immune Defic Syndr. 2002;30:73-80.
Hudson CP. The importance of transmission of HIV-1 in discordant couples in the population dynamics of HIV-1 infection in rural Africa. Int J STD AIDS. 1996;7:302-6.
Sagay AS, Onakewhor J, Galadanci H, Emuveyan EE. HIV status of partners of HIV positive pregnant women in different regions of Nigeria: matters arising. Afr J Med Med Sci. 2006;35Suppl:125-9.
Ezeama CO, Eleje GU, Okonkwo T, Ikechebelu JI. Partner human immunodeficiency virus sero-discordance in Nnewi, Nigeria. J HIV Hum Reprod. 2014;2:2-7.
Onovo A. Prevalence of sero-discordance among pregnant women attending PMTCT services and their partners in Cross-River State, Ngeria.:6th IAS Conference on HIV Pathogenesis and Treatment: Abstract no. CDC338.
Chemaitelly H, Cremin I, Shelton J, Hallett TB, Abu-Raddad LJ. Distinct HIV discordancy patterns by epidemic size in stable sexual partnerships in sub-Saharan Africa. Sex Transm Infect. 2012;88(1):51-7.
Carpenter LM, Kamali A, Ruberantwari A, Malamba SS, Whitworth JA. Rates of HIV-1 transmission within marriage in rural Uganda in relation to the HIV sero-status of the partners. AIDS. 1999;13(9):1083-9.
Lurie MN, Williams BG, Zuma K, Mkaya-Mwamburi D, Garnett GP, Sweat MD, et al. Who infects whom? HIV-1 concordance and discordance among migrant and non-migrant couples in South Africa. AIDS. 2003;17(15):2245-52.
Eyawo O, de Walque D, Ford N, Gakii G, Lester RT, Mills EJ. HIV status in discordant couples in sub-Saharan Africa: a systematic review and meta-analysis. Lancet Infect Dis. 2010;10 (11):770-7.
Guthrie BL, de Bruyn G, Farquhar C. HIV-1-discordant couples in sub-Saharan Africa: explanations and implications for high rates of discordancy. Curr HIV Res. 2007;5(4):416-29.
Damien de Walque (Development Research Group, The World Bank). Discordant couple; HIV infection among couples in Burkina Faso, Ghana, Cameroon, Kenya and Tanzania. 2006.
Ujah I, Ezechi O, Aigbe G. HIV status discordance: associated factors among HIV positive pregnant women in Lagos, Southwest Nigeria. Afr J Reprod Health. 2015;19(2):108-16.
Gray RH, Wawer MJ, Brookmeyer R, Sewankambo NK, Serwadda D, Wabwire-Mangen F, et al. Probability of HIV-1 transmission per coital act in monogamous, heterosexual, HIV-1-discordant couples in Rakai, Uganda. Lancet. 2001;357(9263):1149-53.
Olusanya O, Okpere E, Ezimokhai M. The importance of social class in fertility control in a developing country. West African J Med. 1985;4:205-12.
Serwadda D, Gray RH, Wawer MJ, Stallings RY, Sewankambo NK, Konde-Lule Bongs Lainjo JK, et al. The social dynamics of HIV transmission as reflected through discordant couple in Uganda. AIDS. 1995;9(7):745-50.
Allen S, Tice J, Van de Perre P, Serufilira A, Hudes E, Nsengumuremyi F, et al. Effect of sero-testing with counselling on condom use and seroconversion among HIV discordant couples in Africa. BMJ. 1992;304(6842):1605-9.
Ezeanochie M, Olagbuji B, Ande A, Oboro V. Fertility preferences, condom use, and concerns among HIV-positive women in sero-discordant relationships in the era of antiretroviral therapy. Int J Gynaecol Obstet. 2009;107(2):97-8.
