Uganda Shows Increased HIV Discordant Couples

Health officials have pointed out that the number of HIV discordant couples, where only one partner is infected with the HIV virus, have increased in Uganda.

Commissioner for Community in the Ministry of Health, Dr Sam Okware said that HIV negative partners are at an increased risk of HIV infection from their positive partners. However service providers have still not developed effective counseling programs for discordant couples to prevent infection.

Researchers are still trying to find out what circumstances cause married couples to have different HIV/Aids sero-status.

The Assistant Commissioner National Diseases Control in the Ministry of Health, Dr. Alex Apio pointed out that the number of discordant couples had increased from 4.8 percent last year to 5 percent, indicating the need for couples to use condoms.

The HIV/Aids Sero-Behavioural Survey that was launched on June 19 2006 found that about five percent of about 4,000 cohabiting couples in Uganda were discordant.

The survey revealed that in three percent of the couples, a male partner was infected while the woman was not, while in another 2 percent of the couples, the woman was infected while the man was not.

Discordant couples are more commonly found in polygamous unions as well as more common among urban couples than their rural counterparts.

Kampala reported a higher number of discordant couples than in other regions. In addition Kampala had 5.1 of their couples with an HIV negative man, compared to 2.3, which had an HIV- negative woman.

The West Nile region had the lowest number of discordant couples with only 0.7 percent in both cases.

According to the report, ‘The fact that there are more cohabiting couples who are discordant for HIV than there are cohabiting couples who are both infected, represents an unmet HIV prevention need for the country. This is because the vast majority of these cohabiting couples do not mutually know their HIV status and therefore are not empowered to take action to prevent further spread of the disease.’

About three percent of the couples were both HIV positive.

Okware said that the increasing number of people on Antiretroviral Treatment (ART) probably caused the increase in discordant couples.

‘It is strange, but we think it is partly because there are now more people on ART, which some how gives people a longer life. It is something we have to address quickly because this friendly fire infection is very dangerous to our HIV control measures.’

Hidden infection not detectable by HIV tests has also been put forth as a factor contributing to discordance. Couples identified negotiation of sexual relations as their most formidable challenge. Strategies such as abstinence, condom use, relationship cessation and separation of beds have been suggested as important.