HIV-1 Serodiscordant Couples in Ndjamena (Chad): Analysis of Behavioral Patterns, Viral Load and Antiretroviral Therapy Adherence

The Human Immunodeficiency Virus (HIV) remains a major global public health challenge. By 2022, there were nearly 39.9 million people globally living with HIV, 53% are women and girls. Serodiscordant couples, a couple with one partner positive for HIV, play a critical role in HIV transmission. This is particularly evident in sub-Saharan Africa, where up to 10.90% of couples are serodiscordant, making them a key population for targeted prevention efforts. This study aimed to determine the impact of viral load, antiretroviral therapy (ART) adherence and the behavioral pattern of serodiscordant couple likely to influence HIV transmission. A prospective study was carried out and concerned HIV-1 serodiscordant couples. Parameters such as age, frequency of HIV testing, duration of relationship, number of children, social status, and educational level of partners were analyzed. Questionnaires were used to assess emotional support, communication, and HIV knowledge. Adherence to ART was assessed by pill counting and self-report. Plasma viral load of HIV-positive partners was measured using the GeneXpert platform. Thirty-four (34) HIV-1 serodiscordant couples were included in our study. Women (HIV negative) had an average age of 33 ± 2.21, while the HIV-negative men had an average age of 40.63 ± 1.73. The frequency of HIV testing was 1.60 times/year for women and 2.15 times/year for men. Analysis of viral load showed that, 91.2% of HIV-positive partners had an undetectable viral load, with adherence to ART observed in 91.2%. Open communication and emotional support were present in 88.2% and 72.4% of partners respectively. Our results suggest that HIV non-transmission in these couples is influenced by both treatment adherence which contributed to viral load suppression and positive interpersonal relationships. Emotional support and open communication are key factors that could contribute to preserving the health of serodiscordant couples.