Abstract
This study aims to investigate the human immunodeficiency virus (HIV) transmission rate in HIV serodiscordant couples, in addition to the relevant influencing factors. From January 1999 to August 2016, patients with HIV/AIDS (index cases) along with their fixed partners were registered and monitored to determine the rate of HIV transmission between couples, as well as relevant influencing factors. A total of 231 HIV-positive couples were investigated, of these, 45-negative (19.48%) partners were infected with HIV via sexual transmission prior to diagnosis of the first case detected in couples. After diagnosis, the transmission rate between spouses was 0.39 per 100 person-years (2/507.7), and the cumulative transmission rate was 1.08% (2/186), which was significantly lower than the transmission rate before diagnosis (χ2 = 35.714, P < 0.001). Among the 119 HIV/AIDS patients who received antiretroviral therapy (ART), the transmission rate was 0 (0/119), whereas the transmission rate was 2.99% (2/67) in HIV/AIDS patients who did not receive ART. In addition, HIV transmission rate in serodiscordant couples was high prior to diagnosis of the index case. However, following diagnosis, the transmission rate was reduced, and the risk of transmission in the index case with antiviral treatment was null. Therefore, a prompt intervention in HIV discordant couples with ART of index case is vital to reduce the risk of HIV transmission.
Highlights
In China, there has been a fundamental change in the epidemic pattern of human immunodeficiency virus (HIV), mainly due to blood transmission in the mid-1990s to sexual transmission in recent years [1]
Heterosexual transmission consists of three types: commercial sexual partners, spouses or fixed sexual partners and casual sexual partners, of which transmission between spouses accounts for approximately 20%–40% of cases [5], and is currently taken as one of the important aspects of sexual transmission into account in China [6, 7]
Our current study showed that following diagnosis of the index case, the HIV seroconversion rate among HIV-negative partners was 1/23 of pre-diagnosis as a result of various intervention measures, which was similar to results obtained from previous research [23]
Summary
In China, there has been a fundamental change in the epidemic pattern of human immunodeficiency virus (HIV), mainly due to blood transmission in the mid-1990s to sexual transmission in recent years [1]. In 2016, a total of 115 465 new cases of HIV/AIDS have been reported in China, of which 76 492 (over 66%) were in heterosexuals [2]. Previous studies have shown that heterosexual transmission had become the most widespread method of HIV transmission in mainland China [2,3,4]. A previous study revealed that the transmission rate in serodiscordant couples was 20–25/100 person-years for those who were unaware of their partner’s HIV infection [8]. A research conducted in Africa reported that the transmission rate in serodiscordant couples was significantly lower 5–10/100 person-years for those who were aware of their partner’s HIV infection [9]. It is crucial to explore HIV-index cases as early as possible
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