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College of Medicine and Health
Sciences
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SCHOOL OF PUBLIC HEALTH
DEPARTMENT OF COMMUNITY
HEALTH AND SCIENCE
MASTER OF PUBLIC HEALTH
DISSERTATION
Prevalence of HIV Infection and Factors Associated with
Discordant Couples Receiving
HIV Test in Gasabo District
Case study: Kibagabaga level II Teaching
Hospital
Done by
HABAKUBAHO DESIRE
Reg.NO:
222000904
Supervisor: Ass. Prof. Lawrence RUGEMA
Co-Supervisor: Dr. SIMBI
Clarisse Marie Claudine
September, 2024
DECLARATION
Student name: HABAKUBAHO DESIRE Reg. Number:222000904
Date and signature:/02nd /09/2024
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Co-Supervisor: Dr SIMBI Clarisse Date and signature:
2nd /...09..../ 2024
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Supervisor: Ass. Prof. RUGEMA Lawrence Date and signature:
...2nd /09./ 2024
ACKNOWLEDGEMENT
My heartfelt thanks visit all those who helped me to complete
this research.
I would love to thank the college of Rwanda, the university of
medication and health Sciences,
faculty of Public fitness for his or her support.
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ABSTRACT
Introduction: HIV-discordant couples, where
one partner is infected and the other is not, face significant risks of HIV
transmission within stable relationships. In Rwanda, despite a low overall HIV
prevalence of 3% and limited data on HIV-discordant couples, understanding and
addressing the specific challenges faced by these couples is crucial for
advancing HIV prevention efforts. This study examined the Prevalence of HIV
infection and associated factors among discordant couples who received HIV
tests at Kibagabaga Hospital.
Methods: Using a case study approach, the
research involves 254 discordant couples who went into HIV testing services
from 2020 to 2024, and they were recruited through purposive sampling. Data
collection includes patient interviews and questionnaires, with subsequent
statistical analyses to identify prevalence and risk factors.
Results: Between 2020 and 2024, the overall
HIV prevalence remained at 50% while stratifying in years of 127 cases
positive, in 2020 was 18.1, and in 2022 was 31.5%, and in 2024 was 13.4%. HIV
prevalence over the years kept changing where in 2020 significant associations
with HIV infections including multiple sexual partners (OR: 6.7,
95%CI:2,4-10.30), Age of >45 years (OR: 2.3, 95%CI: 1.1, 5.12), and
Occupation, Driver (OR: 4.77,95%CI: 1.71, 13.31).
Keywords: Prevalence HIV-Discordant Couples,
HIV Infection, HIV Testing, Risk Factors.
TABLE OF CONTENTS
DECLARATION ii
ACKNOWLEDGEMENT iii
ABSTRACT iv
TABLE OF CONTENTS v
LIST OF TABLES viii
LIST OF FIGURES 9
CHAPTER 1. INTRODUCTION 10
1.1 Background 10
1.2 Problem statement Error! Bookmark not
defined.
1.3 Justification of the study 11
1.3.1 To the researchers 11
1.3.2 To the University 12
1.3.3 To the policymakers 12
1.3.4 To the community 12
1.4 Study objectives 12
1.4.1 Main objective 12
1.4.2 Specific objectives 12
1.5 Research questions 13
1.6 Organization of the study 13
CHAPTER 2. LITERATURE-REVIEW 15
2.1 Theoretical-literature-review 15
2.2 Theoretical review 16
2.4 Conceptual-framework 17
CHAPTER3:METHODOLOGY 18
3.1 Studysetting 18
3.3 Study population 18
3.4 Sample size 19
3.5 Sampling technique 19
3.8 Data Analysis 20
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3.9 Ethical-considerations 20
CHAPTER 4: RESULTS 21
4.1. The sociodemographic characteristics
21
4.4. Logistic regression of the associated risk
factors of HIV infection among the
discordant couples 26
CHAPTER 5. DISCUSSION 29
5.1 Implications of the Study 30
5.2 Strengths and Limitations 30
CHAPTER 6. CONCLUSION AND RECOMMENDATIONS
32
6.1 Conclusion 32
6.2 Recommendations 32
REFERENCES 33
Appendix 1. Ethical clearance 41
Appendix 3. Research authorization letter
42
viii
LIST OF TABLES
Table 1: Socio-demographic characteristics (N=254) 21
Table 2: shows the socio-demographic characteristics and HIV
infection among discordant couples
23
Table 3 shows the primary characteristics and HIV infection
among discordant couples 35
Table 4: Logistic regression of the associated risk factors of
HIV infection among the discordant
couples 27
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LIST OF FIGURES
Figure 1:Conceptual framework on the prevalence of HIV
discordance and associated risk
factors among couples receiving HIV test (Source: The
researcher, 2024) 17
Figure 2: shows HIV infection prevalence among discordant
couple 22
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CHAPTER 1. INTRODUCTION
1.1 Background
HIV-discordant couples could benefit from such measures to
help suppress the HIV viral load of the affected companion and decrease the
hazard of HIV transmission to at least 60% (Temam & Ali, 2012)
HIV-discordant couples make a contribution the highest to HIV infections in
Africa, serving as a chance to sound fitness for themselves and their
companions if now not well managed. that is usually now not continually
possible due to the fact maximum discordant companions keep their status away
from their partners for different reasons. young human beings who've intentions
of having married to their friends who aren't superb might face special
demanding situations.
couples who acquired the disease during marriage worry being
stigmatized, deserted, or violated, by their terrible companions once their
repute is understood. most of these have an effect on the mental stories of
HIV-discordant couples in extraordinary ways (Bunnell et al., 2005).
In Tanzania, an HIV and AIDS population-primarily based survey
confirmed that a number of the couples inside the cutting-edge union, ninety 3%
have been HIV concordant negative, 2% have been HIV concordant first-rate even
as five% have been HIV discordant; while in three% of sero-discordant
relationships, guys companion come to be infected and the women were no longer.
In most instances, the proportion of inflamed ladies and men in the ones
relationships is form of similar (Natchu et al., 2012).
In Rwanda, HIV incidence is the bottom in Africa and there may
be limited records on HIV-discordant couples which may also cause a paucity of
critical facts important to improve international HIV desires. For greater than
15 years nowadays, the prevalence of HIV in the entire populace in Rwanda has
remained at 3%, on the equal time as the disease occurrence amongst couples in
Rwanda is 2.9% (Nsanzimana,2019). however the presence of this population,
there is a paucity of records within the literature approximately
HIV-discordant couples. it's far in opposition to the above background that
this test goals to have a have a look at the prevalence of HIV discordance and
related threat elements among couples receiving HIV test so as to reveal
records as a manner to be useful in supporting the lives of sero-discordant
couples and commonly human beings residing with HIV.
1.2 trouble announcement
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the general public of couples are blind to their reputation or
presume to have the same repute as that in their partners (HIV attempting out
with the aid of proxy), which also refers to estimating an character's HIV
repute primarily based on the appeared HIV fame in their sexual associate, in
preference to direct trying out. This technique is regularly utilized in
population-based research where trying out each person is impractical, however
it is able to bring about inaccuracies because of functionality discordance
between partners' HIV statuses.
In Rwanda, no matter improvements in HIV prevention and
remedy, HIV infections amongst couples remains a
e4028a5c6dae3ad5086501ec6f3534d0 undertaking. besides, discordant couples, in
which one accomplice is HIV- 86f68e4d402306ad3cd330d005134dac at the same time
as the alternative is HIV-horrible, face particular demanding situations in
handling their fitness and stopping transmission. despite the importance of
understanding the superiority and determinants of HIV contamination in couples,
there is an opening within the present literature regarding its prevalence and
related hazard factors among couples undergoing HIV trying out (Nsanzimana,
2019)
This look at goals to address this gap via the usage of
investigating the prevalence of HIV infections and discordance and identifying
the danger elements associated with them amongst couples receiving HIV finding
out offerings in Gasabo district, due to the reality this location has a
sizeable metropolis populace with a excessive incidence of HIV discordant
couples. furthermore, Gasabo district has accessible healthcare centers and a
diverse demographic, providing a consultant pattern for statistics the
superiority of HIV infections, discordance and associated danger factors in an
town placing. by the use of information the quantity of infections and
discordance in couples, and the factors contributing to them, interventions can
be tailored extra efficiently to reduce transmission risk and enhance the
overall health effects of each companions.
1.3 Justification of the study
The examine is widespread to the subsequent stakeholders:
1.3.1 To the researchers
This have a take a look at will help researchers make
contributions know-how to the field of HIV/AIDS epidemiology and public
fitness, as it will fill gaps in present literature, presenting a higher
understanding of the prevalence of HIV discordance and its determinants amongst
couples present process HIV trying out.
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