{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T00:25:21Z","timestamp":1774139121253,"version":"3.50.1"},"reference-count":53,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,1,8]],"date-time":"2020-01-08T00:00:00Z","timestamp":1578441600000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01HD084233"],"award-info":[{"award-number":["R01HD084233"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01AI124389"],"award-info":[{"award-number":["R01AI124389"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>High levels of HIV seroconcordance at the population level reduce the potential for effective HIV transmission. However, the level of HIV seroconcordance is largely unknown among heterosexual couples in sub\u2010Saharan Africa. We aimed to quantify the population level HIV seroconcordance in stable heterosexual couples in rural South Africa.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We followed adults (\u226515\u00a0years old) using a population\u2010based, longitudinal and open surveillance system in KwaZulu\u2010Natal, South Africa, from 2003 to 2016. Sexual partnerships and HIV status were confirmed via household surveys and annual HIV surveillance. We calculated the proportions of HIV seroconcordance and serodiscordance in stable sexual partnerships and compared them to the expected proportions under the assumption of random mixing using individual\u2010based microsimulation models. Among unpartnered individuals, we estimated the incidence rates and hazard of sexual partnership formation with HIV\u2010positive or HIV\u2010negative partners by participants' own time\u2010varying HIV status. Competing risks survival regressions were fitted adjusting for sociodemographic and clinical factors. We also calculated Newman's assortativity coefficients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 18,341 HIV\u2010negative and 11,361 HIV\u2010positive individuals contributed 154,469 person\u2010years (PY) of follow\u2010up. Overall, 28% of the participants were in stable sexual partnerships. Of the 677 newly formed stable sexual partnerships, 7.7% (95% CI: 5.8 to 10.0) were HIV\u2010positive seroconcordant (i.e. both individuals in the partnership were HIV\u2010positive), which was three times higher than the expected proportion (2.3%) in microsimulation models based on random mixing. The incidence rates of sexual partnership formation were 0.54\/1000PY with HIV\u2010positive, 1.12\/1000PY with HIV\u2010negative and 2.65\/1000PY with unknown serostatus partners. HIV\u2010positive individuals had 2.39 (95% CI: 1.43 to 3.99) times higher hazard of forming a sexual partnership with an HIV\u2010positive partner than did HIV\u2010negative individuals after adjusting for age, opposite\u2010sex HIV prevalence (by 5\u2010years age groups), HIV prevalence in the surrounding community, ART coverage and other sociodemographic factors. Similarly, forming a sexual partnership with an HIV\u2010negative partner was 1.47 (95% CI: 1.01 to 2.14) times higher in HIV\u2010negative individuals in the adjusted model. Newman's coefficient also showed that assortativity by participant and partner HIV status was moderate (r\u00a0=\u00a00.35).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A high degree of population level HIV seroconcordance (both positive and negative) was observed at the time of forming new sexual partnerships. Understanding factors driving these patterns may help the development of strategies to bring the HIV epidemic under control.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25432","type":"journal-article","created":{"date-parts":[[2020,1,9]],"date-time":"2020-01-09T07:20:58Z","timestamp":1578554458000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["HIV seroconcordance among heterosexual couples in rural KwaZulu\u2010Natal, South Africa: a population\u2010based analysis"],"prefix":"10.1002","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5124-1555","authenticated-orcid":false,"given":"Hae\u2010Young","family":"Kim","sequence":"first","affiliation":[{"name":"Africa Health Research Institute KwaZulu\u2010Natal South Africa"},{"name":"KwaZulu\u2010Natal Research Innovation and Sequencing Platform (KRISP) KwaZulu\u2010Natal South Africa"},{"name":"Department of Population Health New York University Grossman School of Medicine New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6604-491X","authenticated-orcid":false,"given":"Guy","family":"Harling","sequence":"additional","affiliation":[{"name":"Africa Health Research Institute KwaZulu\u2010Natal South Africa"},{"name":"Institute for Global Health University College London London UK"},{"name":"Department of Epidemiology &amp; Harvard Center for Population and Development Studies Harvard T.H. Chan School of Public Health Boston MA USA"},{"name":"MRC\/Wits Rural Public Health &amp; Health Transitions Research Unit (Agincourt) University of the Witwatersrand Johannesburg South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5742-0511","authenticated-orcid":false,"given":"Alain","family":"Vandormael","sequence":"additional","affiliation":[{"name":"Africa Health Research Institute KwaZulu\u2010Natal South Africa"},{"name":"KwaZulu\u2010Natal Research Innovation and Sequencing Platform (KRISP) KwaZulu\u2010Natal South Africa"},{"name":"School of Nursing and Public Health University of KwaZulu\u2010Natal Durban South Africa"},{"name":"Heidelberg Institute of Global Health Faculty of Medicine University of Heidelberg Heidelberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Tomita","sequence":"additional","affiliation":[{"name":"Africa Health Research Institute KwaZulu\u2010Natal South Africa"},{"name":"KwaZulu\u2010Natal Research Innovation and Sequencing Platform (KRISP) KwaZulu\u2010Natal South Africa"},{"name":"Centre for Rural Health School of Nursing and Public Health University of KwaZulu\u2010Natal Durban South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9898-3476","authenticated-orcid":false,"given":"Diego F","family":"Cuadros","sequence":"additional","affiliation":[{"name":"Africa Health Research Institute KwaZulu\u2010Natal South Africa"},{"name":"Department of Geography and Geographic Information Science University of Cincinnati Cincinnati OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4182-4212","authenticated-orcid":false,"given":"Till","family":"B\u00e4rnighausen","sequence":"additional","affiliation":[{"name":"Africa Health Research Institute KwaZulu\u2010Natal South Africa"},{"name":"Heidelberg Institute of Global Health Faculty of Medicine University of Heidelberg Heidelberg Germany"},{"name":"Department of Global Health and Population Harvard T.H. Chan School of Public Health Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9797-0000","authenticated-orcid":false,"given":"Frank","family":"Tanser","sequence":"additional","affiliation":[{"name":"Africa Health Research Institute KwaZulu\u2010Natal South Africa"},{"name":"Department of Epidemiology &amp; Harvard Center for Population and Development Studies Harvard T.H. Chan School of Public Health Boston MA USA"},{"name":"Lincoln Institute for Health University of Lincoln Lincoln UK"},{"name":"Centre for the AIDS Programme of Research in South Africa (CAPRISA) University of KwaZulu\u2010Natal KwaZulu\u2010Natal South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,1,8]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS).UNAIDS Data 2019.Geneva:UNAIDS;2019."},{"key":"e_1_2_9_3_1","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS).Global AIDS Updates 2019.Geneva:UNAIDS;2019."},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60953-8"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw335"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0055060"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2010.507748"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-017-1682-0"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-008-9480-3"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-011-9936-8"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2015.0126"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e328330ed8a"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0012662"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-017-1800-z"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.19.1.21224"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/13691058.2017.1309460"},{"key":"e_1_2_9_17_1","first-page":"218","article-title":"Renegotiating intimate relationships with men: how HIV shapes attitudes and experiences of marriage for South African women living with HIV: \u201cNow in my life, everything I do, looking at my health\u201d","volume":"2013","author":"Cooper D","year":"2013","journal-title":"Acta Jurid (Cape Town)"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001245"},{"issue":"10","key":"e_1_2_9_19_1","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1097\/OLQ.0b013e31805ba84c","article-title":"Heterosexual behavior patterns and the spread of HIV\/AIDS: the interacting effects of rate of partner change and sexual mixing","volume":"34","author":"Hertog S","year":"2007","journal-title":"Sex Transm Dis"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dym211"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.4054\/DemRes.2009.20.13"},{"key":"e_1_2_9_22_1","first-page":"143","article-title":"Women, marriage and domestic arrangements in rural KwaZulu\u2010Natal, South Africa","author":"Hosegood V","year":"2013","journal-title":"Acta Juridica: Marriage, land and custom"},{"key":"e_1_2_9_23_1","unstructured":"KimH\u2010Y CuadrosDF WilkinsonE JunqueiraDM deOliveiraT TanserF.Geographical linkage of HIV transmission in conjugal heterosexual couples in rural KwaZulu\u2010Natal South Africa. In: Institute for Disease Modeling \u2010 7th Annual Disease Modeling Symposium.Seattle WA;2019."},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dym211"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000432473.69250.19"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1228160"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyx134"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000300533.59483.95"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1999.10474144"},{"issue":"2","key":"e_1_2_9_30_1","first-page":"13","article-title":"Mixing patterns in networks","volume":"67","author":"Newman M","year":"2003","journal-title":"Phys Rev"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3181ab5e10"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-14-430"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2013-051368"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11904-013-0188-2"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2017-053178"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2014-205408"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1745-7599.2007.00221.x"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2009.05.044"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0109447"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0153600"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.19.1.20766"},{"issue":"3","key":"e_1_2_9_42_1","first-page":"354","article-title":"Dating and sexual challenges faced by HIV\u2010positive people in KwaZulu\u2010Natal, South Africa","volume":"49","author":"Mulqueeny D","year":"2013","journal-title":"Soc Work"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0163159"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.4054\/DemRes.2009.21.11"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1080\/00224499.2016.1202179"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540120902803208"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-015-1216-6"},{"issue":"1","key":"e_1_2_9_48_1","first-page":"97","article-title":"Disclosure of HIV positive result to a sexual partner among adult clinical service users in Kemissie district, northeast Ethiopia","volume":"16","author":"Seid M","year":"2012","journal-title":"Afr J Reprod Health"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-010-9710-3"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2018.00250"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(15)00080-7"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.aam8012"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2017-209713"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1080\/13691058.2015.1083122"}],"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjia2.25432","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.25432","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jia2.25432","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.25432","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T21:05:01Z","timestamp":1694034301000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jia2.25432"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":53,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,1]]}},"alternative-id":["10.1002\/jia2.25432"],"URL":"https:\/\/doi.org\/10.1002\/jia2.25432","archive":["Portico"],"relation":{},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"value":"1758-2652","type":"print"},{"value":"1758-2652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1]]},"assertion":[{"value":"2019-04-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-11-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-01-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e25432"}}