COMPARISON OF PLASMA VIRAL LOAD AND OTHER PREDICTORS OF TRANSMISSION FROM MEN TO WOMEN AND WOMEN TO MEN IN DISCORDANT COUPLES FROM RWANDA (CLADE A HIV) AND ZAMBIA (CLADE C HIV) Open Access

Stegeman, Chad Jacob (2012)

Permanent URL: https://etd.library.emory.edu/concern/etds/vx021f812?locale=en
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Abstract

A paper among couples in the RZHRG cohort from 1995 to 2000 and found that viral load contributed a significantly larger risk to HIV transmission in woman-to-man (FTM) transmission couples than in man-to-woman (MTF) transmission couples. This paper aims to understand how gender differences in factors of HIV transmission have changed with an additional 12 years of follow-up data. The results showed that controlling for couples' age, genital ulcers, and unprotected coital acts, the viral load estimates for FTM and MTF couples were not statistically different at the 0.05 level with a p-value of 0.309. Further analysis of data that included couples from Ndola, Zambia and Kigali, Rwanda revealed genital ulcers increase the risk of HIV transmission by a factor of 3.14 (2.38, 4.15) for FTM couples, but by a factor of only 2.11 (1.62, 2.74) for MTF couples. The analysis also showed a couple being Zambian compared to Rwandan increased the risk of transmission more for MTF couples than FTM couples. Understanding these gender differences could be an important step in understanding the HIV-1 epidemic in sub- Saharan Africa.

Table of Contents

Literature Review 1

Manuscript

A. Title 11

B. Abstract 12

C. Introduction 13

D. Methods 15

E. Results 18

F. Discussion 22

G. Conclusion 26

H. Acknowledgements 26

I. References 27

J. Tables and Figures 29

Appendix A 37

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