There is no room for complacency about AIDS anywhere. It is estimated some 5 million people become infected with HIV per annum. Since the major means of transmission for the virus is heterosexual intercourse, identifying sero-discordant couples/partners through Voluntary Counseling and Testing (VCT) will have paramount importance to mitigate the epidemic. This study aims to assess the prevalence of HIV sero-discordant test results and possible socio-demographic and behavioral determinants. Assessment of post-test reaction of discordant couples and perceived competency of counselors towards couple counseling will also be assessed. The study is retrospective crossectional study design based on simple random sampling of couples tested for HIV in 2004/5. The Ethiopian Standard VCT client record formats was sorted chronologically to serve as sampling frame. The calculated sample size for the quantitative study was 601 couples (1202 individuals). Qualitative data was generated from counselors and peer supervisors to enrich the quantitative data and address issues not addressed quantitatively.