Prevalence and Factors Associated with HIV Serodiscordance Among Couples Attending Iganga General Hospital-Iganga District, Eastern Uganda

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