Prevalence and predictors of HIV sero-discordance among cohabiting couples tested in northern

Tanzania

David P. Ngilangwa1, 2*.Rhoune Ochako3, Beati Mboya1., Rita Noronha1., George S. Mgomella2,4

 1Amref Health Africa, P.O Box 2773 Dar es Salaam, Tanzania2Kilimanjaro Reproductive Health Program, Moshi, Tanzania

3Population Services International, Nairobi, Kenya4University of Cambridge, Worts’ Causeway, Cambridge CB1 8RN, UK

1st Amref Health Africa International Conference

Safari Park Hotel, Nairobi, Kenya

24-26th November, 2014

Outline

• Background

• Methods

• Results

• Conclusion

• Acknowledgments

Background• More HIV infections occur among heterosexual

couples

• HIV sero-discordance—accounts for 75% of all HIV infected couples(20-49yrs)

• Early sexual debut, concurrent partnerships and socio-cultural practices lead to Sero-discordance

• Living in such relationships increases the odds of new infections by 30%

• In Tanzania, 5% are in sero-discordant relationships

Background…• Majority do not know their sero-status (75%)

• High rate of mortality attributable to HIV infection

• Utilisation of Couples’ HIV Counselling and Testing (CHCT) services remain to be critical in preventing new infections

• We aimed to establish prevalence and predictors of HIV sero-discordance among couples tested in Moshi and Arusha in northern Tanzania.

Methods

• A cross-sectional study using quantitative method

• Interviewed 1,400 couples aged 18-49 years tested from 2005 to 2007 in Kilimanjaro and Arusha regions

• A CHCT checklist was used to collect data from

couples

• Data were analyzed using STATA 10

Results: Study participants• A total of 1,333 (95.2%) out of 1400 couples were

eligible to participate in this study.

• Mean age was (31.63 ± 9.53) years

• Majority of the couples 1, 153 (86.5%) had men partners slightly older

• 690(52%) were tested in Arusha

• 1% of tested couples were from neighbouring towns

• Urban dwellers

Results: Discordance prevalence • HIV prevalence by couples was as follows;

– 1,050 (79%) were concordant negative– 63 (5%) were concordant positive– 220 (16%) were HIV sero-discordant

• Among the HIV sero-discordant couples

– 63 (29%) couples had HIV positive male partners

– 157 (71%) had HIV positive female partners

Results…

Results…

Limitations • Self-selection of couples

• Self-reporting of couples

Conclusion • HIV discordance prevalence was high among

our participants

• CHCT utilization should be promoted widely as entry for treatment as prevention strategy

Acknowledgement

o The Bill and Melinda Gates

o Study respondents

o Kilimanjaro Reproductive Health Programme

(Collaborative research efforts of Harvard

School of Public Health and Kilimanjaro

Christian Medical Centre)