Abstract
BACKGROUND: Heterosexual transmission of HIV among married couples is the commonest mode of transmission seen in India. Intramarital transmission is associated with several challenges which need to be further researched. AIM: To study level of seroconcordance and serodiscordance among HIV positive couples and factors affecting intramarital sexual transmission in terms of safe sexual practice, and the presence of Sexually transmitted infections (STI)/circumcision. MATERIALS AND METHODS: Ninety-one monogamous married cohabiting HIV-positive cases (index cases) attending Department of Skin and Venereology, Medical College Baroda, from January 2009 to August 2009 were studied. Their spouses were tested for HIV. A structured proforma was used to study various factors like condom use, circumcision, and the presence of sexually transmitted infections. RESULTS: Ninety-one monogamous married cohabiting HIV-positive cases were included in the study and considered as index cases. There were 51 males and 40 females. On testing their spouses for HIV, both the spouses were positive in 55 couples giving rise to 60% seroconcordance rate. Out of 55 seroconcordant couples, male spouses used condom in 16 cases (29%). Out of 36 serodiscordant couples 17 male spouses (47%) used condom. Evidence of STD was observed in one of the spouses in 6 out of 55 seroconcordant couples and 6 out of 36 serodiscordant couples. Thus, out of 91 couples one of the partners was having STI in 12 couples. Overall rate of circumcision was 12.2%. CONCLUSION: The prevention of transmission of HIV to the HIV negative partner is of paramount importance. Serodiscordant couples, specially the HIV negative female partner is at higher risk. Less acceptability of condoms among married couples may be one of the factors responsible in transmission. Further studies are needed to explore other risk factors associated with HIV transmission in discordant couples.