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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/24013

Title: A flexible method to model HIV serodiscordance among couples in Mozambique
Authors: Juga, Adelino J. C.
Hens, Niel
Osman, Nafissa
Aerts, Marc
Issue Date: 2017
Publisher: PUBLIC LIBRARY SCIENCE
Citation: PLoS One, 12(3), p. 1-14 (Art N° e0172959)
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.
Notes: [Juga, Adelino J. C.] Eduardo Mondlane Univ, Dept Math & Informat, Fac Sci, Maputo, Mozambique. [Juga, Adelino J. C.; Hens, Niel; Aerts, Marc] Hasselt Univ, BioStat I, Diepenbeek, Belgium. [Hens, Niel] Univ Antwerp, Vaccine & Infect Dis Inst VAXINFECTIO, Ctr Hlth Econ Res & Modelling Infect Dis, Antwerp, Belgium. [Hens, Niel] Univ Antwerp, Epidemiol & Social Med ESOC, Fac Med & Hlth Sci, Antwerp, Belgium. [Osman, Nafissa] Maputo Cent Hosp, Dept Obstet & Gynaecol, Maputo, Mozambique. [Osman, Nafissa] Eduardo Mondlane Univ, Fac Med, Maputo, Mozambique.
URI: http://hdl.handle.net/1942/24013
Link to publication: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5416904/
DOI: 10.1371/journal.pone.0172959
ISI #: 000396011300053
ISSN: 1932-6203
Category: A1
Type: Journal Contribution
Appears in Collections: Research publications

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