Couples HIV testing and immediate antiretroviral therapy for serodiscordant HIV-positive partners: Translating evidence into programme in Vietnam

Int J STD AIDS. 2019 Jul;30(8):739-747. doi: 10.1177/0956462418825405. Epub 2019 May 2.

Abstract

Injection drug use and heterosexual transmission from male key populations to their female partners have been the dominant modes of HIV transmission in Vietnam. A demonstration project was conducted to offer immediate antiretroviral therapy (ART) (regardless of CD4 cell count) to HIV-seropositive partners in serodiscordant couples. During March–December 2013, couples HIV testing and counselling (HTC) and immediate ART were offered in two drug use-affected provinces. Of 256 couples receiving couples HTC, 146 (57%) were serodiscordant; 134 (92%) seropositive partners initiated ART irrespective of CD4 cell count. Of these, 86% were male; 57% reported ever using illicit drugs; median CD4 cell count before ART initiation was 374 cells/mm3. Consistent condom use was reported by 58, 70 and 71% among HIV-positive partners at months 0, 3 and 12. At 12 months after ART initiation, 119 (89%) HIV-positive partners were retained in care; 96 (95% of those tested) achieved viral suppression (<1000 copies/ml). Uptake of immediate ART and viral suppression among those initiating ART were high, paving the way for ART regardless of CD4 cell count as national policy in Vietnam.

Keywords: Antiretroviral therapy; Asia; HIV; prevention.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active*
  • Feasibility Studies
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • HIV Infections / prevention & control*
  • HIV Infections / transmission
  • HIV Seropositivity / diagnosis*
  • HIV Seropositivity / drug therapy
  • Heterosexuality / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Sexual Partners
  • Vietnam / epidemiology

Substances

  • Anti-HIV Agents