Human Immunodeficiency Virus (HIV) serodiscordance and associated factors among HIV positive clients accessing anti- retroviral therapy in Ogun State South West Nigeria

Abstract

Background: Sub-Saharan Africa has the highest prevalence and incidence of HIV infection worldwide, mostly attributable to heterosexual transmission. In Nigeria, the bulk of the new infections occurs in persons who are not engaging in high-risk sex, a subpopulation that includes cohabiting or married sexual partners.

Objectives: This study was undertaken to determine the prevalence and assess factors associated with HIV serodiscordance status among HIV positive patients accessing ART in secondary health facilities in Ogun State, South West Nigeria.

Methods: This is a descriptive cross-sectional study conducted in four secondary health facilities offering HIV services in Ogun State over a six months period. A sample size of 630 was determined using the Cochrane formula and the respondents were consecutively recruited into the study. Data was collected using a structured intervieweradministered questionnaire and analysis were done using the statistical package for social sciences (SPSS) version 17.0. Results were presented using frequency tables, tests of associations was done using the Chi-square test and multiple Logistic regression with level of significance set at 0.05

Results: Two hundred and Seventy-eight (43.6%)of the respondents did not know their spouse HIV status while 359 knew partners status. Of the 359, 166 clients are serodiscordant (46.2%) while 193 (53.8%) were seroconcordant. The mean age was 35.8 ± 9.1years. More of the younger age have serodiscordant partners. Significantly more females (74.7%) than males (25.3%) had serodiscordant partners (p-value= 0.002). Clients who did not consume alcohol were significantly more likely to have serodiscordant partners compared with clients who consume alcohol (p-value=0.001). Serodiscordant partners were significantly more among clients with infrequent sexual activities compared with clients with frequent sexual activities (p-value=0.001). Predictors of serodiscordance status among partners were clients who were <35 years old (odd ratio (OR) =1.727, confidence interval (CI) =1.107-2.693) and did not consumed alcohol (OR =2.204, CI = 1.070-4.542), with partners whose occupation were skilled (OR=7.159, CI=1.440-35.604) and semi-skilled (OR=6.189, CI=1.216-31.503) and clients with infrequent sexual activities (OR=3.182, CI=1.437-7.046).

Conclusion: The study indicates that HIV positive clients could have serodiscordant partners if they could modify their lifestyle, have infrequent sexual activities (Not more  than twice in a month) with partners that are gainfully engaged. It is therefore recommended that for early identification of at-risk partners, couple HIV counseling and testing needs to be scaled up in addition to group-based interventions in order to pick serodiscordant partners early and provide all the necessary behavioral change support required to remain serodiscordant.

Keywords: Factors, HIV Serodiscordance partners, clients, ART, Secondary health facilities