West and Central Africa had approximately 6.5 million people living with HIV in 2015 and women accounted for nearly 60%. In the same year, the region recorded 410,000 new HIV infections and 330,000 people died of AIDS-related causes.1 Nigeria is second to South Africa with the highest burden of HIV globally and in 2014, the country was home to 3,391,546 people living with HIV and recorded 227,518 new HIV infections with males contributing 103,917 and females 123,601 new HIV infections. In the same year, the number of deaths from AIDS-related causes was put at 174,253 in Nigeria.2
The ambitious goal of the global community to end AIDS epidemic as a public health threat by 2030 will be feasible only when a reduction in HIV transmission through 90-90-90 is matched to a much more robust reduction in the risk of HIV acquisition.3, 4
It is reported that sub-Saharan Africa (SSA) has the highest prevalence and incidence of HIV infection globally, mostly from heterosexual transmission.5, 6 The prevalence of HIV among HIV sero-discordant heterosexual couples is high in most SSA countries,7, 8 and although the contribution to the spread of HIV by key populations is significant, heterosexual sex, particularly of the low-risk type still makes up about 2% in Rwanda, 13% in Zambia and Lesotho, and in Nigeria 80% of new HIV infections.9, 10, 11, 12 In a study conducted in Nigeria on the mode of HIV transmission in 2008, two-fifths of new HIV infections occurred in the general population, among persons who are not engaging in high-risk sex that includes cohabiting or married sexual partners considered as low-risk population.2
In HIV discordant heterosexual couples in Africa, Men are generally regarded as the source of HIV in the relationship, and are referred to as “index case”.13, 14 However, in most studies of sero-discordant relationships, half of the index cases are male and half are female. In a cohort study involving 13,061 sero-discordant couples in SSA and DHS involving 1,145 sero-discordant couples in 14 countries, the proportion of HIV positive women in stable heterosexual sero-discordant relationships was 47%.15
In view of the emerging role of concurrent relationships in fuelling the HIV epidemic,16, 17, 18 HIV sero-discordance is now recognized as a priority for HIV prevention activities, as it can influence transmission of infection not only within adults but between mother and child and the development of antiretroviral drug resistance.19, 20 Despite growing evidence of its importance; the concept of “sero-discordance” and the frequency of its occurrence are poorly understood by HIV stakeholders in our settings, resulting in the insufficient emphasis on necessary treatment strategies that can protect the negative partner and improve the life of the positive clients. There are few studies on the burden of HIV sero-discordance among cohabiting partners in Plateau state, this study sought to determine the prevalence and pattern of HIV sero-discordance among pregnant women and their partners in Plateau state.