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AIDS Behav. 2018 Jun;22(6):1775-1786. doi: 10.1007/s10461-017-1947-7.

Individual, Partner, and Couple Predictors of HIV Infection among Pregnant Women in Malawi: A Case-Control Study.

Author information

1
UNC Project, University of North Carolina at Chapel Hill, Lilongwe, Malawi. Nora_Rosenberg@unc.edu.
2
School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Nora_Rosenberg@unc.edu.
3
UNC Project, Tidziwe Centre, Private Bag A-104, Lilongwe, Malawi. Nora_Rosenberg@unc.edu.
4
UNC Project, University of North Carolina at Chapel Hill, Lilongwe, Malawi.
5
School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
6
Faculty of Medicine and Faculty of Social, Human, and Mathematical Sciences, University of Southampton, Southampton, England, UK.
7
School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
8
Department of Epidemiology, Ohio State University, Columbus, OH, USA.

Abstract

We aimed to understand drivers of HIV-infection in pregnant women in Malawi. The study was conducted in antenatal and labor and delivery wards. HIV-infected women and their partners (cases) were frequency matched in a 1:2 ratio based on age and screening location to HIV-uninfected women and their partners (controls) in a prevalent case-control study. Characteristics associated with female HIV infection were assessed using logistic regression modeling. At screening, HIV-infected women were more likely to have partners outside Lilongwe than HIV-uninfected women (24% vs. 0%, p < 0.0001). Case females were more likely to have HIV-infected study partners than control females (75% vs. 4%, p < 0.0001). The odds of female HIV-infection were higher if either couple member reported ≥ 2 lifetime marriages (OR 9.0, CI 2.6-30.9) or ≥ 3 lifetime partners (OR 18.0, CI 3.1-103.6) and lower if either reported past couple HIV testing and counseling (OR 0.1, CI 0.04-0.3). Targeting women with migrating partners, promoting couple HIV testing and counseling, and limiting partners could slow HIV transmission.

KEYWORDS:

Counseling; Couple; HIV; Prevention; Risk; Testing

PMID:
29086117
PMCID:
PMC5927853
[Available on 2019-06-01]
DOI:
10.1007/s10461-017-1947-7

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