Factors influencing HIV seroconversion rate in Chinese heterosexual discordant couples: A systematic review and meta-analysis

Background: At present, there are few studies focusing on the factors affecting the seroconversion rate of serodiscordant couples, but the number of serodiscordant couples is increasing, which has become a serious global public health problem.We sought to identify factors contributing to HIV seroconversion of the uninfected spouse in couples serodiscordant for the virus. Methods We used a systematic literature search to identify studies describing serodiscordance and seroconversion among couples in which one partner was infected with HIV. We conducted a meta-analysis of 18 published articles in which we combined the random-effects models to identify factors contributing to seroconversion.Forest plots, sensitivity analysis and Egger’s regression asymmetry test were performed by STATA SE-64 (version 12) to measure the overall results, stability of results and bias. Heterogeneity was tested by I2 statistic. Results The overall seroconversion rate was lower in the ART-receiving group [odds ratio (OR) = 0.34, 95% confidence interval (CI) (0.16; 0.71)], demonstrating that ART is effective in preventing HIV transmission. Farmers had greater odds of HIV transmission than those who were not farmers [OR = 1.28, 95% CI(1.07; 1.52)]. Further, the serodiscordance rate was higher in intravenous drug abusers [OR = 0.76, 95% CI(0.66; 0.87)]. However, HIV patients and AIDS patients had no statistical differences in serodiscordance rates [OR = 1.38, 95% CI(0.81; 2.35)]. Conclusions These findings suggest that promoting early and long-term access to ART treatment, developing a rural HIV prevention model, and focusing on families of drug addicts may be beneficial interventions for reducing HIV transmission. Further research should explore the effects of ART intervention in different periods (HIV/AIDS).