Review and Follow up Findings on HIV Serodiscordance among Couples in Benue State Nigeria

Abstract

Background: Sexual contact with an HIV infected individual is a significant risk in HIV transmission. We observed occurrence of HIV sero-discordance among some couples in our environment and went further to determine the prevalence of such discordance in Benue state, Nigeria. Aim: To report HIV discordance rate among couples attending some antenatal care clinics in Benue state, Nigeria in order to stimulate search for factors responsible for such discordance. Methodology: This study was carried out in collaboration with the Site Coordinators of Preventionof-Mother-to-Child-Transmission (PMTCT) programs in Benue State, Nigeria. Antenatal care clients attending HIV/AIDS Counseling T BMRJ, 5(2): 180-185, 2015; Article no.BMRJ.2015.019 181 requested to come along with her spouse at the next follow up visit for partner counseling and screening. Socio-demographic data were obtained from all subjects. A group of discordant couples were followed up till December, 2012. Results: A total of 3,508, 5,531, and 4,475 women were counseled and screened annually from 2006 to 2008. HIV positive patients recorded in those years were 15.8%, 17.4% and 46.5% respectively. The peak HIV prevalence occurred in the 21-30 years age group. Among the positive patients, the following percentages accepted partner notification; 53.5% (2006), 72.0% (2007), 67.3% (2008) and came back on consequent follow up visit with their partners while 25%, 15.7%, 47.0% partners accepted to be screened in 2006, 2007 and 2008 respectively. Among the partners screened, there was a sero-discordance of 46% (n=34/74) in 2006. 57% (n=62/109) in 2007 and 45.3% (n= 298/658) in 2008. The highest incidence of HIV sero-discordance occurred among couples < 5 years old in marriage(40%), couples with history of sexually transmitted infections in the past one year(55%) and male circumcision(30% in uncircumcised, 70% in circumcised). Among a cohort of 20 discordant couples consecutively followed up, 80% of the couples were still seen and sero discordant four years after the initial discovery. Conclusion: We recommend risk-reduction behavior, empowerment of vulnerable groups, effective life planning skills as well as behavioral and cultural change among couples. This group of patients can be a major study point for identification of possible factors responsible for prevention of HIV transmission. These findings should guide prevention interventions in order to achieve maximal impact.