1. Prevalence and predictors of HIV sero-discordance among cohabiting couples tested in northern Tanzania David P. Ngilangwa 1, 2*.Rhoune Ochako 3, Beati Mboya 1., Rita Noronha 1., George S. Mgomella 2,4 1 Amref Health Africa, P.O Box 2773 Dar es Salaam, Tanzania 2 Kilimanjaro Reproductive Health Program, Moshi, Tanzania 3 Population Services International, Nairobi, Kenya 4 University of Cambridge, Worts’ Causeway, Cambridge CB1 8RN, UK 1 st Amref Health Africa International Conference Safari Park Hotel, Nairobi, Kenya 24-26 th November, 2014

2. Outline Background Methods Results Conclusion Acknowledgments

3. Background More HIV infections occur among heterosexual couples HIV sero-discordance—accounts for 75% of all HIV infected couples(20-49yrs) Early sexual debut, concurrent partnerships and socio- cultural practices lead to Sero-discordance Living in such relationships increases the odds of new infections by 30% In Tanzania, 5% are in sero-discordant relationships

4. Background… Majority do not know their sero-status (75%) High rate of mortality attributable to HIV infection Utilisation of Couples’ HIV Counselling and Testing (CHCT) services remain to be critical in preventing new infections We aimed to establish prevalence and predictors of HIV sero-discordance among couples tested in Moshi and Arusha in northern Tanzania.

5. Methods A cross-sectional study using quantitative method Interviewed 1,400 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

6. Results: Study participants A total of 1,333 (95.2%) out of 1400 couples were eligible to participate in this study. Mean age was (31.63 ± 9.53) years Majority of the couples 1, 153 (86.5%) had men partners slightly older 690(52%) were tested in Arusha 1% of tested couples were from neighbouring towns Urban dwellers

7. Results: Discordance prevalence HIV prevalence by couples was as follows; – 1,050 (79%) were concordant negative – 63 (5%) were concordant positive – 220 (16%) were HIV sero-discordant Among the HIV sero-discordant couples – 63 (29%) couples had HIV positive male partners –157 (71%) had HIV positive female partners

8. Results…

10. Limitations Self-selection of couples Self-reporting of couples

11. Conclusion HIV discordance prevalence was high among our participants CHCT utilization should be promoted widely as entry for treatment as prevention strategy

12. Acknowledgement o The Bill and Melinda Gates o Study respondents o Kilimanjaro Reproductive Health Programme (Collaborative research efforts of Harvard School of Public Health and Kilimanjaro Christian Medical Centre)