Table of contents
Declaration............................................................................................................................. i
Approval...............................................................................................................................ii
Dedication............................................................................................................................iii
Acknowledgement ............................................................................................................... iv
Table of contents................................................................................................................... v
List of tables ...................................................................................................................... viii
List of acronyms .................................................................................................................. ix
Operational definitions.......................................................................................................... x
Abstract ............................................................................................................................... xi
CHAPTER ONE ................................................................................................................. 1
INTRODUCTION............................................................................................................... 1
1.1 Background ................................................................................................................. 1
1.2 Problem Statement ...................................................................................................... 2
1.3 Objectives of the Study ........................................................................................... 2
1.3.1 Main Objective.................................................................................................... 2
1.3.2 Specific Objectives.............................................................................................. 2
1.4 Research Questions................................................................................................. 2
1.5 Significance of the Study ........................................................................................ 2
1.6 Scope of the Study .................................................................................................. 3
1.6.1 Time Scope ......................................................................................................... 3
1.6.2 Content Scope ..................................................................................................... 3
1.6.3 Geographical Scope............................................................................................. 3
1.7 Conceptual Framework ........................................................................................... 4
CHAPTER TWO ................................................................................................................ 5
LITERATURE REVIEW ................................................................................................... 5
2.1 HIV Sero Discordance Phenomenon ....................................................................... 5
2.2 Prevalence of HIV Sero-discordance ....................................................................... 5
2.3 Factors Associated with Sero Discordance among Couples ..................................... 6
2.3.1 Gender of the HIV positive partner...................................................................... 6
2.3.2 HIV viral load of the HIV positive partner........................................................... 6
2.3.3 Use of ARV by the HIV positive partner ............................................................. 6
2.3.4 Other Sexually transmitted infections (STIs) ....................................................... 6
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2.3.5 Male circumcision ............................................................................................... 7
2.3.6 Sexual Practice .................................................................................................... 7
CHAPTER THREE ............................................................................................................ 8
METHODOLOGY.............................................................................................................. 8
3.1 Study Design ............................................................................................................... 8
3.2 Study Area .................................................................................................................. 8
3.3 Study Population ......................................................................................................... 8
3.4 Sample Size Determination.......................................................................................... 8
3.5 Sampling Technique .................................................................................................... 9
3.6 Selection Criteria......................................................................................................... 9
3.6.1 Inclusion Criteria ...................................................................................................... 9
3.6.2 Exclusion Criteria..................................................................................................... 9
3.7 Data Collection Methods............................................................................................. 9
3.8 Data Analysis .............................................................................................................. 9
3.9 Data Quality Control ................................................................................................... 9
3.10 Data Presentation....................................................................................................... 9
3.11 Study Limitations and Delimitations.......................................................................... 9
3.12 Ethical Considerations............................................................................................. 10
CHAPTER FOUR............................................................................................................. 11
RESULTS.......................................................................................................................... 11
4.1 Socio-demographic characteristic of participants................................................... 11
4.2 Prevalence of HIV among participants.................................................................. 12
4.3 Prevalence of HIV sero-discordance among participant couples............................ 12
4.4 Discordance among infected couples..................................................................... 12
4.5 Factors associated with HIV sero- discordance among participants ....................... 13
4.5.1 Gender and HIV discordance ............................................................................. 13
4.5.2 Sexual practice and HIV sero-discordance ......................................................... 13
4.5.3 Type of marriage and HIV sero discordance ...................................................... 13
4.5.4 Condom use and discordance............................................................................. 14
4.5.5 History of other STIs and HIV sero-discordance................................................ 14
4.5.6 ARV use and discordance.................................................................................. 14
4.5.7 Viral load and discordance................................................................................. 14
4.5.8 Male circumcision and discordance ................................................................... 15
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CHAPTER FIVE............................................................................................................... 16
DISCUSSION, CONCLUSIONS AND RECOMMENDATIONS .................................. 16
5.1 Discussion............................................................................................................. 16
5.1.1 Prevalence of HIV sero discordance among participant couples......................... 16
5.1.2 Factors associated with HIV sero-discordance among participant couples.......... 16
5.1.2.1 Gender of the positive partner and HIV sero-discordance............................... 16
5.1.2.2 Presence of other STIs and HIV sero-discordance .......................................... 16
5.1.2.3 Sexual practice and HIV sero-discordance ..................................................... 16
5.1.2.4 Male circumcision and HIV sero-discordance ................................................ 17
5.1.2.5 Use of ARVs by the partner and HIV sero-discordance .................................. 17
5.1.2.6 Condom use and HIV sero-discordance......................................................... 17
5.2 Conclusions .......................................................................................................... 17
5.3 Recommendations................................................................................................. 18
REFERENCES.................................................................................................................. 19
APPENDICES................................................................................................................... 21
Appendix I: Consent Form ......................................................................................... 21
Appendix II: Questionnaire.......................................................................................... 22
Appendix III: A map of Iganga District showing Iganga municipal council where Iganga
general hospital is located................................................................................................ 25
Abstract Background: HIV sero-discordance refers to a situation where in a pair of long term sexual partners, one is HIV positive and the other is HIV negative. There is an increased risk of HIV transmission to the HIV negative partner in discordant couples which makes HIV serodiscordance a hindrance to HIV control and prevention strategies. Sero-discordance is one of the factors affecting the impact of HIV prevention strategies, therefore effective HIV prevention strategies must consider HIV discordance. Limited knowledge about prevalence of HIV sero-discordance in the community hinders formulation of appropriate strategies for effective control of HIV transmission. The study was aimed at determining the prevalence of HIV sero-discordance and its associated factors among couples attending Iganga General Hospital. The knowledge generated will guide the stakeholders in formulating HIV prevention and control strategies aimed at reducing HIV transmission. Methods: A cross-sectional hospital-based study was carried out through conduction of guided interviews using a questionnaire to random-systematically selected 250couples attending IGH. Data was analyzed and presented in tables with percentages comparing different factors. Results: The HIV sero-prevalence was 6.8%. The prevalence of discordance was 4.8% among participant couples and 52.2% among the infected couples. HIV sero-discordance was associated with sexual practice (83.3%), circumcision status of the male partner in the couple (58.3%), condom use (58.3%), use of ARVs by the HIV infected partner (25%) and experience of STIs among partners (25%). Conclusion: The prevalence of HIV sero-discordance among the participant couples was 4.8%, associated mainly with sexual practice, circumcision and condom use.