SEXUAL AND REPRODUCTIVE HEALTH NEEDS AND PRACTICES: A COMPARATIVE STUDY OF HIV DISCORDANT AND CONCORDANT COUPLES ACCESSING CARE AT COMPREHENSIVE HEALTH CENTERS IN A SOUTHEASTERN STATE IN NIGERIA.

Chinomnso C. Nnebue*, Adaeze N. Anaekwe, Chidebe O. Anaekwe and Alphonsus C. Obi-Okaro

ABSTRACT

Background: A comprehensive picture of the sexual and reproductive health needs and practices of HIV- discordant couples is key in improving the efficacy of interventions for them. Objective: To compare the sexual and reproductive health needs and practices of HIV discordant and concordant couples in comprehensive health centers in Anambra state, Nigeria. Materials and methods: This was a cross-sectional comparative study of 289 (148 HIV-concordant and 141 HIV-discordant) couples, selected using multistage sampling technique. Quantitative data were collected by interview using semi-structured questionnaire and analysed with statistical package for social sciences version 22.0. Chi-square and fishers exact tests were used to determine statistically significant associations between variables. A p value < 0.05 was significant. Qualitative data were elicited by focus group discussions. Results: More concordant couples 142(49.3%), compared to 122(42.4%) discordant counterparts were sexually active (p = 0.001); more discordant couples had sexual concerns to share (p = 0.05); 74(26.3%) concordant couples compared to 68(23.5%) discordant ones, had children post HIV diagnosis (p= 0.255); while. 77(26.6%) concordant couples desire to have children compared to 70(24.2%) discordant ones (p = 0.731). Eight (2.8%) concordant and none of the discordant couples, practiced artificial conception methods, (p=0.007), the primary reason for not practicing artificial methods, among concordant couples was the feeling it was unnecessary, while for discordant couples, was poor knowledge (p = 0.01). Conclusion: This study found variations in use of condoms; knowledge and or practice of family planning methods, emergency contraception, artificial contraception as well as sexual concerns to share among discordant and concordant couples. We recommend that these findings be factored in designing novel couple-level intervention strategies.

Keywords: couples, sero-discordance, HIV, sexual and reproductive health practices, Nigeria.