Determinants of Sexual and Reproductive Health Practices of HIV Discordant and Concordant Couples Attending Comprehensive Health Centers in Anambra State, Nigeria

Background: People in discordant partnerships still deserve the right to enjoy sexual relations, and decide whether or not to have children while at the same time taking care not to infect the negative partner and the unborn child. Objective: To identify and compare factors influencing the sexual and reproductive health practices of HIV- concordant and discordant couples attending comprehensive health centers in Anambra state. Materials and methods: This was a cross-sectional comparative study of 289 (148 HIV-concordant and 141 HIV-discordant) couples, selected by a multistage sampling technique. Data were collected by interview using semi-structured questionnaire and analysed with statistical package for social sciences version 22.0. The models that met the criteria for significance, include: a statistically significant chi-square in the omnibus test ( 0.05), Nagelkerke’s R square of at least 0.65. Results: Presence of support from religious circle and female age < 35 at couples' HIV diagnosis appear to encourage HIV couples to bear children (p=0.007 and p<0.000) respectively. Predictor variables that were significantly associated with satisfaction with sexual relationship (p<0.05), and contributed to model significance (p<0.05) consisted of female partner duration on HIV treatment, and safe sex practice method. Conclusions: This study revealed key determinants of the sexual and reproductive health practices of HIV- concordant and discordant couples. Such factors should form the basis for designing novel couple-targeted preventive strategies.