title: Prevalence and predictors of HIV sero-discordance among cohabiting couples tested in northern Tanzania.
abstract: BACKGROUND
  In sub-Saharan Africa where HIV/AIDS epidemic is predominantly generalized, majority of HIV infections occur among heterosexual couples. The majority of people do not know their sero-status. Thus, utilisation of Couples' HIV Counselling and Testing (CHCT) services remain to be critical in preventing new infections. The objective was to establish prevalence and predictors of HIV sero-discordance among cohabiting couples presenting for CHCT services in northern Tanzania.
  
  
  METHODS
  A cross-sectional study inteveviewed 1,333 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
  Generally, 220(16%) out of 1,333 couples were HIV sero-discordant. In sero-discordance unions, women were likely to be HIV positive than men (71% versus 29% respectively p<0.001). HIV sero-discordant relationship was associated with age (35-45 years) for both men and women (Adjusted Odds Ratio (AOR): 2.3, 95% Confidence Interval (CI): 1.7-3.2) and (AOR: 2.6, 95% CI 1.9-3.7) respectively. Women with older men partners were less likely to be in HIV sero-discordance relationships (AOR: 0.5 95% CI 0.3-09). Arusha couples were likely to be HIV sero-discordant than those of Kilimanjaro (AOR: 2.3 95% CI 1.7-3.2). Couples living far away from CHCT centres were less likely to be sero-discordant than those live nearby (AOR: 0.4 95% CI 0.2-0.9).
  
  
  CONCLUSIONS
  HIV sero-discordance prevalence is high among our participants. Thus, we recommend CHCT utilization should widely be promoted as entry point in treatment as prevention strategy in order to protect uninfected partners in HIV sero-discordance relationships.
authors.affiliation: Amref Health Africa, P.O Box 2773 Dar es Salaam, Tanzania; Kilimanjaro Reproductive Health Program, Moshi, Tanzania.
authors.forename: David Paul
authors.initials: DP
authors.lastname: Ngilangwa
authors.affiliation: Population Services International, Nairobi, Kenya.
authors.forename: Rhoune
authors.initials: R
authors.lastname: Ochako
authors.affiliation: Amref Health Africa, P.O Box 2773 Dar es Salaam, Tanzania.
authors.forename: Beati Alphonce
authors.initials: BA
authors.lastname: Mboya
authors.affiliation: Amref Health Africa, P.O Box 2773 Dar es Salaam, Tanzania.
authors.forename: Rita Honoratha
authors.initials: RH
authors.lastname: Noronha
authors.affiliation: Kilimanjaro Reproductive Health Program, Moshi, Tanzania; Department of Medicine, Strangeways Research Laboratory, University of Cambridge, Worts' Causeway, Cambridge CB1 8RN, UK.
authors.forename: George Suleman
authors.initials: GS
authors.lastname: Mgomella
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology*; D018023:HIV Seronegativity; D006679:HIV Seropositivity; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012737:Sex Factors; D012747:Sexual Partners; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult
keywords: HIV; Tanzania; cohabiting couples; prevalence; sero-discordance