Assessment of HIV Discordance and Associated Risk Factors Among Sexual Partners Receiving HIV Test in Dilla, Ethiopia

Background: About 60% of new HIV infections occur in HIV sero-discordant couples as 30% of married HIV positives have negative spouse. Although HIV-discordant couples are at 10% annual risk of acquiring HIV infection and large number of new HIV infections occur in stable partnerships, most HIV prevention programs focus on reducing casual sexual partners, condom use, and increasing fidelity among married partners. Objective: Assessment of sero-discordant sexual partners and associated factors to mitigate propagation of HIV. Methods: The study was facility based cross sectional survey of sexual partners who tested for HIV in 2011 and lived together at least 1 year period. The sample size was 150 couples (300 individuals) and necessary ethical issues were considered. Results: Among 150 couples (300 individuals) who received VCT, the overall prevalence of sero-discordance was 5.3%. The 3.3% prevalence in females was higher than 2.7% in males. Married couples were significantly discordant than pre sexual couples, AOR= 1.68; 95%CI (1.36- 5.40). HIV discordance was also significantly associated with having number of two or more sexual partners than one sexual partner AOR=4.06; 95%CI (2.41-10.13). Conclusion and recommendations: The study indicated significant prevalence of HIV discordance and showed increased risk of vulnerability to HIV infection. Therefore, couples should be aware of their own and their partners' sero-status before and after engagement and the following risk reduction methods were recommended: counsellors should be trained on talks of sexual or relationship to counsel discordant couples; education of discordant couples on 100% correct condom use, and if condom breaks, or if they forget to use one, Post-Exposure Prophylaxis must be established; for those who are not volunteer to use condom, early initiation of ART to positive partner; and for a woman who is HIV positive and wants to have a child, the system for artificial insemination is important.