Women and men in sub-Saharan Africa are equally likely to be the index partner in a couple where only only partner is HIV-positive, according to a systematic review published in the November 2010 issue of The Lancet Infectious Diseases. These results have important implications for prevention strategies.

Although most social marketing aimed at reducing extramarital relationships is targeted at men, efforts should also take into account the role of women, review authors said. Similarly, both men and women in relationships should be informed about the need for condom use when HIV status is unknown. Although the man’s role in infecting the female partner has been the dominant focus in prevention strategies, the emphasis should be revised in the context of stable couples, since uninfected men and women seem to have an equal chance of having a stable partner who has HIV.

1. Eyawo O, de Walque D, Ford N, et al. HIV status in discordant couples in sub-Saharan Africa: a systematic review and meta-analysis. Lancet Infectious Diseases 2010; 10(11): 770-777 (open access; free registration required)