Challenges Faced by HIV Positive Partners Living in Discordance with HIV Negative Partners : A Case Study of 37 Military Hospital

Background: According to the HIV Sentinel Survey 2015, there has been a gradual decrease in the trend prevalence of HIV in Ghana. Studies conducted in the African sub-region have however identified the phenomenon of discordance as the main driving force in the incidence of the disease. Discordance in HIV refers to a pair of long-term sexual partners in which one is retroviral positive and the other is not. Interestingly, some of these studies have estimated that over 70% of new infections occur in serodiscordant marital/co-habiting relationships. Regardless of the cause of discordance, some of these couples, upon disclosure, encountered challenges such as the disintegration of the union, negotiations for sexual relations, job losses, stigmatization by family and friends, financial strains due to ill health, fear of infecting the children/partner and the fear of dying. This study aimed at critically analyzing the possible challenges encountered by discordant couples in their relationship and ascertained if the demographic details of the positive partners being on ARVs had any correlation on the challenges encountered. Methods: A sample of 40 patients living in discordance was drawn purposively from the patients attending the ART Clinic (Antiretroviral Therapy) at the 37 Military Hospital in Accra, Ghana. Questionnaires were administered and the data compiled and analyzed using STATA 13. Descriptive statistics, including percentages and frequencies were used to capture and analyze the various challenges faced by such couples. Further, Chi-square tests, Fisher’s exact test and multiple regressions where necessary was used to examine whether socio-demographic characteristics like gender, age, educational level and religion had a significant association on challenges faced by the discordant couples. Results and Conclusions: Fear of infecting their kids, dying, financial strain and inconsistent use of condoms were some of the main challenges encountered by respondents. There was, however, a significant correlation between gender and challenges such as financial strain (p=0.01) and fear of infecting kids (p=0.001). We find that most of the HIV-positive respondents who have had some form of education claim that their negative partners are supportive and committed to staying in the relationship. More Christians than Muslim respondents appeared not to be confronted by constant threats of separation/divorce (p=0.02) from their negative partners. We posit that our findings highlight relevant issues relating to discordance which, though important have received little attention. For example, our finding that regular use of condoms by discordant couples appeared to be a real challenge in spite of the risk of transmission to the negative partner suggests the need for more education. Overall, our findings suggest that more work and resources need to be pumped into awareness creation of the potential welfare challenges faced by discordant couples with an emphasis on preventive strategies to forestall transmission among such couples, thereby mitigating both physical and psychological stresses they may be facing.