Comparison of sexual behavior and HIV risk between two HIV-1 serodiscordant couple cohorts: the CHAVI 002 study

The CHAVI002 study was designed to characterize immune responses, particularly HIV-specific T-cell responses, amongst 2 cohorts of HIV-exposed seronegative (HESN) individuals. The absence of a clear definition of HESNs has impaired comparison of research within and between such cohorts. This report...

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Published in:PloS one Vol. 7; no. 5; p. e37727
Main Authors: Ritchie, Adam J, Kuldanek, Kristin, Moodie, Zoe, Wang, Z Maggie, Fox, Julie, Nsubuga, Rebecca N, Legg, Kenneth, Birabwa, Esther F, Kaleebu, Pontiano, McMichael, Andrew J, Watera, Christine, Goonetilleke, Nilu, Fidler, Sarah
Format: Journal Article
Language:English
Published: United States Public Library of Science 22-05-2012
Public Library of Science (PLoS)
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Summary:The CHAVI002 study was designed to characterize immune responses, particularly HIV-specific T-cell responses, amongst 2 cohorts of HIV-exposed seronegative (HESN) individuals. The absence of a clear definition of HESNs has impaired comparison of research within and between such cohorts. This report describes two distinct HESN cohorts and attempts to quantify HIV exposure using a 'HIV risk index' (RI) model. HIV serodiscordant couples (UK; 24, Uganda; 72) and HIV unexposed seronegative (HUSN) controls (UK; 14, Uganda; 26 couples, 3 individuals) completed sexual behavior questionnaires every 3 months over a 9 month period. The two cohorts were heterogeneous, with most HESNs in the UK men who have sex with men (MSM), while all HESNs in Uganda were in heterosexual relationships. Concordance of responses between partners was determined. Each participant's sexual behavior score (SBS) was estimated based on the number and type of unprotected sex acts carried out in defined time periods. Independent HIV acquisition risk factors (partner plasma viral load, STIs, male circumcision, pregnancy) were integrated with the SBS, generating a RI for each HESN. 96 HIV serodiscordant couples completed 929 SBQs. SBSs remained relatively stable amongst the UK cohort, whilst decreasing from Visit 1 to 2 in the Ugandan cohort. Compared to the Ugandan cohort, SBSs and RIs in the UK cohort were lower at visit 1, and generally higher at later visits. Differences between the cohorts, with lower rates of ART use in Uganda and higher risk per-act sex in the UK, had major impacts on the SBSs and RIs of each cohort. There was one HIV transmission event in the UK cohort. Employment of a risk quantification model facilitated quantification and comparison of HIV acquisition risk across two disparate HIV serodiscordant couple cohorts.
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Conceived and designed the experiments: ZM KL EFB PK AJM CW NG SF. Performed the experiments: KK EFB CW SF. Analyzed the data: AJR ZM ZMW JF RNN SF. Wrote the paper: AJR KK ZM SF.
Current address: Uganda Virus Research Institute, Entebbe, Uganda
Current address: Infectious Disease Institute, Kampala, Uganda
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0037727