HIV Sero-Discordance among Heterosexual Couples in Sub-Saharan Africa

Jacob A. Adetunji, U.S. Agency for International Development (USAID)

Although protection of uninfected partner is a best practice in HIV prevention, we know very little about the level, patterns and determinants of HIV sero-discordance among couples in Africa. Using nationally representative data from six sub-Saharan African countries, we analyze matched couple files to investigate the extent of the problem, its pattern, and the characteristics of sero-discordant couples. The results show that the proportion of HIV-positive sero-discordant couples is higher than the proportion that is sero-concordant in all study countries except Lesotho. In Tanzania, Kenya and Cameroon, the proportion of sero-discordant couples is at least twice the proportion sero-concordant. The man is more likely than the woman to be the infected partner in most countries. In rural settings, and among the less educated and the poor, men are more likely to be the infected partner. The implications of these findings are discussed in the context of HIV prevention in Africa.