Sexually Transmitted Infections and Treatment Practices: A Comparative Study of HIV Discordant and Concordant Couples Accessing Care at Comprehensive Health Centers in Anambra State, Nigeria

Background: The prevalence of sexually transmitted infections (STI) among HIV affected couples has implications for containment of infectiousness of HIV. Understanding correlates of STI among discordant couples could boost the effectiveness of antiretroviral interventions.

Objective: To compare the STI occurrence and treatment 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 by multistage sampling technique. Data were collected by interview using semi-structured questionnaire and analysed with statistical package for social sciences version 22.0. Tests of statistical significance were done using chi-square and fishers exact tests and p values <0.05 were significant.

Results: The mean ages ±SD were 41.1±19.3 years for males and 34.4±9.1 years for female, while 142 (49.3%) concordant couples, compared to 122 (42.4%) discordant counterparts were sexually active (p = 0.001), 61 (22.9%) of these do not use condoms (p = 0.401), 104 (35.9%) had previously treated STI. Gonorrhoea in males 61(89.7%) and candidiasis in females 25 (65.8%) were the commonest STI. More concordant couples had both partners ever treated STI (p = 0.004). Frequency of sexual intercourse (p=0.007) and occasional or never used condoms (p=0.037) were associated with more history of previous STI treatment.

Conclusion: This study found that more concordant couples had both partners ever treated STI, while frequent sexual intercourse and occasional or never use of condoms, both more in discordant than concordant couples, were associated with more history of previous STI treatment. We therefore recommend couple-level STI interventions that combine treatment and behavioral change communication.