Demographic and clinical characteristics, sexual behaviours, CD4 cell count and plasma HIV-1 RNA loads were measured at enrolment and longitudinally over 12 months of follow-up. The study included 70 cases who seroconverted during study follow-up and 167 matched controls who remained persistently serodiscordant. The incidence of HIV infection among the initially seronegative partners was 6.52 per 100 person-years. Persistently discordant patients were more likely to have initiated highly active

antiretroviral therapy (HAART) than patients in seroconverting relationships (62.9%vs. 42.9%) (P=0.001). Patients in seroconverting relationships had significantly higher plasma viral loads (PVLs) than patients in discordant relationships

find more at enrolment, at 6 months and at 12 months (P<0.05). Patients in seroconverting relationships were less likely to use condoms with their primary partners than patients in discordant relationships (P<0.05). Patients in relationships that seroconverted between 6 and 12 months were diagnosed more often with genital Herpes simplex than patients in discordant check details relationships (P=0.001). In the univariate and multivariate logistic regression, the following variables were associated with seroconversion: PVL >100 000 [odds ratio (OR): 1.82; 95% confidence interval (CI): 1.1–2.8], non-disclosure of HIV status (OR: 5.5; 95% CI: 4.3–6.2) and not using condoms (OR: 2.8; 95% CI: 2.4–3.6). Couples-based intervention models are crucial in selleck compound preventing HIV transmission to seronegative spouses. Providing early treatment for sexually transmitted infections, HAART and enhancing condom use and disclosure could potentially decrease the risk of HIV transmission within Indian married couples. An increasing focus of HIV preventive strategies has been to move away from solely reducing the risk-taking behaviours of HIV-uninfected individuals to focusing on HIV-infected individuals who may continue to practice HIV risk-taking

behaviours [1]. Studies from the developed and developing world have documented that a sizeable number of HIV-infected individuals continue to engage in unprotected sexual intercourse with HIV-serodiscordant partners [2–6]. Unprotected intercourse may be more common among HIV-infected individuals in steady or regular relationships than in casual or non-regular sexual encounters [7]. Additionally, high plasma HIV-1 RNA levels and sexually transmitted infections (STIs) may put the HIV-uninfected partner at continued risk of infection [8–16]. These findings suggest that there are multiple biological and behavioural risk factors for HIV transmission among individuals in serodiscordant relationships where the HIV status of the partner is known. In traditional societies, the use of preventive measures by HIV-uninfected partners may be further hampered by social stigma, reproductive issues and gender inequality [17]. In India, it is estimated that 2.