In the most recent issue of the Lancet Infectious Diseases, Eyawo et al published findings from a systematic review of data on couples of people with HIV that showed, contrary to prior belief, women are as likely as men to be in the index case in the relationship. This has important implications, they suggest, because "most social marketing and awareness campaigns are focused on men."
They cite that the yearly risk of infection for a partner of a person with HIV is about 10%, [Hugonnet] and up to 95% of new HIV infections in Rwanda and Zambia are in couples living together (KL Dunkle).
Their conclusion: "Our study shows the need to focus on both sexes in HIV prevention strategies, such as promotion of condom use and mitigation of risk behaviours. ... Finally, although the man's role in infecting the female partner has been the dominant focus in prevention strategies, the emphasis should be revised in the context of stable couples, since uninfected men and women seem to have an equal chance of having a stable partner who has HIV."
What significance will this finding have for your programs?
The analysis reviewed data on 27 cohorts of 13,061 couples and DHS data from 14 countries of 1,145 couples.
1. Eyawo O, de Walque D, Ford N, et al. HIV status in discordant couples in sub-Saharan Africa: a systematic review and meta-analysis. The Lancet Infectious Diseases. 2010;10(11):770-777.
Find the study here: http://www.thelancet.com/journals/laninf/article/PIIS1473-3099%2810%2970189-4...