| A flexible method to model HIV serodiscordance among couples in Mozambique |
| Authors: |
Adelino J. C. Juga, Niel Hens, Nafissa Osman, and Marc Aerts |
| Source: |
PLOS ONE , 12(3): e0172959. doi:10.1371/journal. |
| Topic(s): |
HIV/AIDS
|
| Country: |
Africa
Mozambique
|
| Published: |
MAR 2017 |
| Abstract: |
Whereas the number of people newly infected by HIV is continuing to decline globally, the
epidemic continues to expand in many parts of the world. As the HIV/AIDS epidemic has
matured in many countries, it is believed that the proportion of new infections occurring
within couples has risen. Across countries, including Mozambique, a sizeable proportion of
couples with HIV infection are discordant. A serodiscordant couple is a couple in which one
partner has tested positive for HIV and the other has not. To describe the HIV serodiscordance
among couples, a variety of association measures can be used. In this paper, we propose
the serodiscordance measure (SDM) as a new alternative measure. Focus is on the
specification of flexible marginal and random effects models for multivariate correlated
binary data together with a full-likelihood estimation method, to adequately and directly
describe the measure of interest. Fitting joint models allows examining the effects of different
risk factors and other covariates on the probability to be HIV positive for each member
within a couple, and estimating common effects for both probabilities more efficiently, while
accounting for the association between their infection status. Moreover, the interpretation of
the proposed association parameter SDM is more direct and relevant and effects of covariates
can be studied as well. Results show that the HIV prevalence for the province where a
couple was located as well as the union number for the woman within a couple are factors
associated with HIV serodiscordance. These findings are important for the Mozambican
public health policy makers to design national prevention plans, which include policies to
stimulate regular HIV testing for couples as well as adolescents and young adults, prior to
getting married or living together as a couple. +¬ |
| Web: |
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0172959 |
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