Abstract
As people with HIV (PWH) age with improved antiretroviral therapy (ART), understanding health outcomes in cohabiting couples whether seroconcordant or serodiscordant has become increasingly important for comprehensive HIV care. This study investigated viral load suppression rates, hypertension, and diabetes prevalence among HIV-infected individuals in seroconcordant and serodiscordant cohabiting relationships and identified demographic and clinical factors associated with these outcomes. This hospital-based study analyzed 247 adults (>18 years) with HIV, comprising 176 individuals from seroconcordant couples and 71 HIV-infected individuals from serodiscordant couples. Participants' mean age was 47.59 ± 10.61 years, with a mean ART duration of 13.29 ± 5.43 years. The overall viral suppression rate was 97.6%, while hypertension prevalence was 9.3% and diabetes prevalence was 2.8%. Enhanced adherence counselling (EAC) for prior virologic failure was provided for 6.5% of participants. Concordance status did not significantly affect viral suppression (p = 0.7) or hypertension prevalence (p=0.8). However, seroconcordant couples had significantly longer ART duration (14.02 vs 11.24 years, p<0.001), while serodiscordant couples had longer cohabitation duration (20.83 vs 17.99 years, p=0.033). Despite excellent overall suppression, participants on second-line ART regimens had 93% lower odds of viral suppression compared to first-line recipients [adjusted odds ratio (aOR)=0.07, 95% confidence interval (CI): 0.01–0.76, p=0.028]. Those with a history of EAC had similarly reduced suppression odds of viral suppression (aOR=0.11, 95% CI: 0.01–0.94, p=0.044). Male sex and higher body mass index were independent predictors (aOR=3.13, 95% CI: 1.15–9.09, p=0.025 and aOR=1.12, 95% CI: 1.02–1.23, p=0.014, respectively). These findings underscore that partner HIV status does not influence clinical outcomes but highlight important needs for sustained adherence support in patients with complex treatment histories and targeted cardiovascular risk management in the ageing population of PWH.
Keywords
Seroconcordant, Serodiscordant, HIV, Viral suppression, Adherence, Non-communicable diseases