Background: The transmission of the Human Immunodeficiency Virus (HIV) during heterosexual intercourse is one of the leading modes of transmission at the origin of the global epidemic of HIV infection. Studies have indeed shown that in Sub-Saharan Africa, most women infected today are infected by their spouses, in the context of marital sexual relations. Objective: The objective of this study was to describe the sociodemographic, clinical and therapeutic characteristics of HIV serodiscordant couples in Kinshasa. Methods: This study is a cross-sectional descriptive study of HIV serodiscordant couples followed in Kinshasa. Data on socio-demographic, clinical and therapeutic characteristics were collected from a questionnaire during couples’ interviews. Results: 17 serodiscordant couples were included in the study. The average time spent as a couple was 8.6 ± 1.8 years. 71.4% of HIV-positive partners were in the age group between 36 and 45 years. According to the BMI, 35.2% of HIV-positive people have normal weight, 11.7% are overweight and 2.9% are thin. 47% of serodiscordant couples had intercourse 4 to 10 times, 41.7% had 1 to 3 times and 11.7% had more than 10 times per month. For the duration of ARV treatment, 28.5% of the seropositive have been under ARV treatment for 1 year, 21.4% for 10 years old, and 14.2% for 3 years. Conclusion: All partners were informed of the serological status of their spouses. It appears in this study, more than half of the infected people are women.
For a long time, the epidemic of Human Immunodeficiency Virus (HIV) infection was mainly studied from the angle of key populations: Pregnant Women, Professional Sex Workers (PSWs), Truck Drivers, Migrants, etc [
Heterosexual transmission of HIV is one of the major modes of transmission driving the global HIV epidemic [
In African societies, where various types of unions coexist (polygamous and monogamous unions, formal and informal unions, customary and legal unions), defining what the notion of couple covers is a perilous undertaking. The types of couples are multiple, and conjugal relationships are currently undergoing profound changes [
The use of HIV testing remains rare on the African continent. The vast majority of people living in Africa have not been tested for HIV and live in fear of being infected, without knowing their HIV status [
The objective of this study was to describe the sociodemographic, clinical and therapeutic characteristics of serodiscordant couples for HIV in Kinshasa, Democratic Republic of the Congo.
This study was a descriptive cross-sectional one that was conducted among discordant couples for HIV infection in Kinshasa. The type of sampling was appropriate given the rarity of discordant couples. Were included in this present study all discordant couples for HIV followed at the Monkole Hospital Center and at the Sainte Anne Health Center. The two centers were selected because of the attendance of couples of interest and accessibility. All couples freely agreed to participate in the study and signed the informed consent.
Sociodemographic, clinical and therapeutic data and data on the risks of sexual transmission of HIV, as well as information relating to their life as a couple were collected using a pretested questionnaire during couples’ interviews.
The population of this study was composed mainly of adults in couples where one of the spouses/partners was tested positive for HIV infection in the treatment center.
The sociodemographic and anthropometric data studied were: age group, level of education, religion, profession, height, weight and Body Mass Index (BMI).
The clinical data studied were: the screening method used, the frequency of sexual intercourse, the clinical status of the partners, and the clinical stage of the partners according to the WHO.
The data on the therapeutic attitude were: the therapeutic regimen, the duration of treatment, previous exposure to Antiretroviral Treatments (ARTs) and the rational use of condoms.
All these information was collected on anonymous forms. Only the investigators were in direct contact with the patients. Once the survey sheets were completed, the rest of the study was carried out using the numbers assigned to the sheets. The information was recorded on the survey sheets, and entered on the Windows Excel software. Statistical data analyzes were performed on SPSS version 20.0.
・ People living in a couple: according to the African connotation, i.e. people living in a union for several years.
・ Normal clinical state: state of the patient in which the vital functions of the patient are normal, the patient is able to do everything without assistance.
・ Couples serodiscordant for HIV: A couple is said to be serodiscordant for HIV, when one of the spouses or partners is positive for HIV after tests and not the other, both live under the same roof for some years.
This study had received the approval of the Ethics and Scientific Committee of the Kinshasa School of Public Health (ESP/CE/115/2021). The agreement of the managers of the centers in which the study was done was also obtained.
Seventeen couples were included in the study, 14 couples at the Monkole Hospital Center (CHM) and 3 at the Saint Anne Health Center (SAHC), after signing the informed consent (
It appears from this study that 52.9% of female partners are affected by HIV. The most represented age groups are that of 36 and 45 years and that of more than 46 years or 41.18% of the patients each. The revival religion was the majority with 35.2% of couples, followed by the Catholic religion with 29.4% of couples. The majority of partners (61.7%) had a level of education limited to secondary school, followed by 41.7% at primary level and 23.5% at university level. The informal employment sector was the majority with 44.1% of partners, followed by 11.7% of housewives, 8.8% of electronics technicians, and 5.8% of taxi drivers... For positive spouses, 35.2% had a Body Mass Index (BMI) equivalent to a normal weight, 11.7% was overweight and 2.9% was lean; while among negative spouses, 23.5% were overweight, 20.5% had normal weight and 5.8% had mild obesity.
All patients were screened by an indirect method as recommended by the national HIV/AIDS program; these are rapid diagnostic tests (Determine and Unigold). Most couples (47%) declare having had 4 to 10 sexual intercourses per month over the past twelve months, 41.7% declare having had 1 to 3 sexual intercourses per month, and 11.7% declare having had more than 10 sexual
| Serological State | CH Monkole | CS Saint Anne | Total | |||
|---|---|---|---|---|---|---|
| Men | Women | Male | Women | Men | Women | |
| Seropositive | 7 | 7 | 1 | 2 | 8 | 9 |
| Seronegative | 7 | 7 | 2 | 1 | 9 | 8 |
| Total | 14 | 14 | 3 | 3 | 17 | 17 |
intercourses per month. All the negative spouses had a normal clinical state while 70.5% of the positive spouses had a normal clinical state and 29.5% had a good clinical state. Nevertheless, 47.1% were at clinical stage 2 according to the World Health Organization (WHO), 29.4% were at clinical stage 3, and 23.5% were at clinical stage 1.
Most couples (88.2%) do not rationally use condoms, while 11.8% affirmed they
| Parameters | CH Monkole | CS Saint Anne | Total | |||
|---|---|---|---|---|---|---|
| VIH+ | VIH− | VIH+ | VIH− | VIH+ | VIH− | |
| Age Interval (years) | ||||||
| 18 - 25 | 1 | 0 | 0 | 0 | 1 | 0 |
| 26 - 35 | 0 | 3 | 1 | 1 | 1 | 4 |
| 36 - 45 | 10 | 4 | 0 | 0 | 10 | 4 |
| >46 | 3 | 7 | 2 | 2 | 5 | 5 |
| Total | 14 | 14 | 3 | 3 | 17 | 17 |
| Body Mass Index (kg/m2) | ||||||
| <18.5 | 0 | 0 | 1 | 0 | 1 | 0 |
| 18.5 - 25 | 11 | 6 | 1 | 1 | 12 | 7 |
| 25 - 30 | 3 | 7 | 1 | 1 | 4 | 8 |
| 30 - 35 | 0 | 1 | 0 | 1 | 0 | 2 |
| >35 | 0 | 0 | 0 | 0 | 0 | 0 |
| Total | 14 | 14 | 3 | 3 | 17 | 17 |
| Prior Exposition to ART | ||||||
| YES | 13 | 2 | 0 | 0 | 13 | 2 |
| NO | 1 | 12 | 3 | 3 | 4 | 15 |
| Total | 14 | 14 | 3 | 3 | 17 | 17 |
| Clinical State of PLHIV | CH Monkole | CS Saint Anne | Total |
|---|---|---|---|
| State 1 | 4 | 0 | 4 |
| State 2 | 8 | 0 | 8 |
| State 3 | 2 | 3 | 5 |
| State 4 | 0 | 0 | 0 |
| Total | 14 | 3 | 17 |
do. Less than half of the patients (44.1%) had been previously exposed to ART. All positive spouses were put on the Dolutegravir + Lamivudine + Tenofovir (DTG/3TC/TDF) regimen as the first-line regimen. More than a quarter (28.5%) of positive spouses have been on ART for less than a year, 21.4% have been on ART for 10 years, and 14.2% have been on ART for 3 years.
The objective of this study was to describe the sociodemographic, clinical and therapeutic characteristics of serodiscordant couples for HIV infection in Kinshasa, Democratic Republic of the Congo. Seventeen couples were recorded for this study, 14 couples at the Monkole Hospital Center and 3 couples at the Saint Anne Health Center. For it is unusual to officially record serodiscordant couples for HIV in Kinshasa.
32.3% of the partners are from the province of Bandundu followed by the province of Kongo Central with 29.4% of the partners. Of 100% of people from Bandundu, 54.5% are HIV-negative. Of 100% of people from Kongo Central, 55.5% are also HIV-negative. We observe that in these two provinces the percentage of seronegatives is high compared to the percentage of seropositives. Further studies will allow us to understand the mapping of serodiscordant couples in the Democratic Republic of the Congo to better elucidate and understand the rate of HIV-negative people living in a couple in all the 516 health zones of the country.
61.7% of the partners had a secondary level against 23.5% of the university level, 41.7% had a primary level. The level of knowledge improves the management
| Parameters | CH Monkole | CS Saint Anne | Total |
|---|---|---|---|
| Rational Use of Condoms | |||
| YES | 2 | 0 | 2 |
| NO | 12 | 3 | 15 |
| Total | 14 | 3 | 17 |
| Frequency of Sexual Intercourses on the Last 12 Months | |||
| NON | 0 | 0 | 0 |
| 1 - 3 time/month | 6 | 1 | 7 |
| 4 - 10 time/month | 6 | 2 | 8 |
| >10 time/month | 2 | 0 | 2 |
| Total | 14 | 3 | 17 |
| Parameters | CH Monkole | CS Saint Anne | Total | |||
|---|---|---|---|---|---|---|
| VIH+ | VIH− | VIH+ | VIH− | VIH+ | VIH− | |
| Province of Origin | ||||||
| BANDUNDU | 5 | 6 | 0 | 0 | 5 | 6 |
| EQUATEUR | 1 | 1 | 0 | 0 | 1 | 1 |
| KASAI ORIENTAL | 2 | 0 | 0 | 0 | 2 | 0 |
| KASAI OCCIDENT | 2 | 1 | 1 | 0 | 3 | 1 |
| KATANGA | 0 | 2 | 0 | 0 | 0 | 2 |
| KONGO CENTRAL | 2 | 3 | 2 | 2 | 4 | 4 |
| MANIEMA | 0 | 0 | 0 | 1 | 0 | 1 |
| NORD KIVU | 1 | 0 | 0 | 0 | 1 | 0 |
| SUD KIVU | 1 | 1 | 0 | 0 | 1 | 1 |
| Total | 14 | 14 | 3 | 3 | 17 | 17 |
| Tribe of Origin | ||||||
| AKULA | 1 | 0 | 0 | 0 | 1 | 0 |
| BAMBOMA | 0 | 0 | 1 | 1 | 1 | 1 |
| KUBA | 0 | 1 | 0 | 0 | 0 | 1 |
| LODJA | 0 | 0 | 1 | 0 | 1 | 0 |
| LUBA | 4 | 0 | 0 | 0 | 4 | 0 |
| MBALA | 2 | 3 | 0 | 0 | 2 | 3 |
| MBATA | 1 | 1 | 0 | 0 | 1 | 1 |
| MUHUNDE | 1 | 0 | 0 | 0 | 1 | 0 |
| MUTANDU | 0 | 1 | 1 | 1 | 1 | 2 |
| NGANI | 1 | 0 | 0 | 0 | 1 | 0 |
| NGOMBE | 0 | 1 | 0 | 0 | 0 | 1 |
| REGA | 1 | 1 | 0 | 1 | 1 | 2 |
| SAKATA | 0 | 3 | 0 | 0 | 0 | 3 |
| SONGE | 0 | 2 | 0 | 0 | 0 | 2 |
| TANDU | 1 | 1 | 0 | 0 | 1 | 1 |
| WUNGANI | 1 | 0 | 0 | 0 | 1 | 0 |
| YANSI | 1 | 0 | 0 | 0 | 1 | 0 |
| Total | 14 | 14 | 3 | 3 | 17 | 17 |
of the disease and also the level of acceptance of the pandemic. Because 71.4% of HIV-positive partners were already at the HIV disease stage. Understanding the disease could improve care for those concerned.
On the age group and sex affected, our data corroborate with that published by the journal of medicine and health sciences [
35.2% of HIV-positive people had an ideal weight (in the range of the BMI interpretation recommendation) against 11.7% who were overweight and 2.9% who were lean. The overweight partners either knew how to overcome the disease and correctly follow the lessons taught during appointments for care or were exposed by our postman. The poor health status of thin partners was linked to opportunistic infections during treatment (Tuberculosis).
Regarding the frequency of sexual intercourse and the use of condoms, 47% of serodiscordant couples had 4 to 10 sexual intercourse, 41.7% had 1 to 3 times and 11.7% had more than 10 times per month, compared to those who found the frequency of sexual intercourse per week in their study in Ivory Coast to be 1 or 2 times (20.9%), 2 times (29.1%) [
All partners were informed of the HIV status of their spouses. The average life together as a couple was 8.6 years. It appears in this study, more than half of the infected people are women and the people allegedly healthy serologically were healthy from the clinical point of view.
The authors would like to thank the patients of the centers who agreed to participate in this study, and all the teams of service providers from the outpatient treatment centers of Kinshasa who participated. A very special thank is addressed to the Biochemistry Laboratory of the Faculty of Pharmaceutical Sciences of the University of Kinshasa.
The authors declare no conflicts of interest.
Inkale, C.B., Makoka, S.K., Woto, I., Mbikayi, S., Ilunga, A.K.K., Kabengele, G.K., Kilara, T.K., Banzulu, N., Tshilenge, C., Bongenya, B.I. and Kamangu, E.N. (2023) Sociodemographic, Clinical and Therapeutic Characteristics of Serodiscordant Couples for the Human Immunodeficiency Virus Followed in Kinshasa: A Case of CH Monkole and Saint Anne Health Center. Open Access Library Journal, 10: e9678. https://doi.org/10.4236/oalib.1109678
ART: Antiretroviral Treatment;
BMI: Body Mass Index;
DRC: Democratic Republic of the Congo;
PCR: Polymerase Chain Reaction;
PLHIV: Person Living with HIV.