Objective: To analyze the sero-conversion rate and risk factors among HIV discordant couples in Zhumadian.
Methods: Sero-discordant couples had been followed up during 2006 - 2011. Information were collected from the National Comprehensive HIV/AIDS Information Management System and the HIV discordant couples Follow-up Management Information System including demographic characteristics of sero-negative spouses, the characteristics of infection and antiretroviral therapy information of index spouses, marital sexual behavior and social support etc., on a biannual basis. Blood specimens of sero-negative spouses were also collected and tested. Cox proportional-hazard model was used to analyze the related risk factors on HIV sero-conversion.
Results: Among 4813 sero-discordant couples, 127 HIV sero-conversion spouses were identified, with a total sero-conversion rate as 0.63 per 100 person-years. The one-year sero-conversion rate in 2006 - 2011 ranged from 0.29 to 1.28 per 100 person-years. Factors that associated with increased risk of HIV sero-conversion were: sero-negative spouses with lower education level (RR = 1.50, 95%CI: 1.02 - 2.21, P = 0.04), index spouses not received ART (RR = 3.16, 95%CI: 2.20 - 4.56, P < 0.01) and last recorded CD4(+) cell counts as < 200 cells per µl (RR = 2.11, 95%CI: 1.40 - 3.19, P < 0.01), marital sexual contacts in the past 6 months with frequency of ≥ 4 times per month (RR = 4.27, 95%CI: 2.89 - 6.30, P < 0.01) but never used condoms (RR = 6.40, 95%CI: 3.67 - 11.17, P < 0.01), couples had not received any financial support and care assistance in the past 6 months (RR = 4.75, 95%CI: 2.34 - 9.64, P < 0.01).
Conclusion: During 2006 - 2011, the sero-conversion rate among sero-negative spouses in Zhumadian had been stabilized and the rate was lower than it was in the last years. The increase of ART acceptance and its adherence and social support should be improved and focused on the follow-up management towards the serodiscordant couples.