Background: Couples Voluntary Counseling and Testing (CVCT) is an effectivernHIV prevention strategy for couples who represent the largest risk group inrnAfrica. In this region, less than 1% of couples tested for HIV. Of the estimatedrn100 infections per day in many African countries 70% occurs in cohabitingrncouples. In Ethiopia, there are only few couple based VCT studies conducted.rnNarrowing the gap of knowledge in these matters will help as a baseline for otherrnstudies. Furthermore it helps in forming strategies and specific interventions torndeal with drawback of CVCT program.rnObjectives: The aim of this study was to determine the magnitude of couplesrncoming to VCT centers and to assess the factors associated with use and nonusernof CVCT services in Addis Ababa.rnMethods: A cross sectional study in 6 government hospital VCT sites in AddisrnAbaba city was conducted in the month of April, 2007.rnUsing quota sampling method, the 875 individuals who fulfilled the criteria whorntook VCT/CVCT service were included in the study consecutively until thernrequired sample was obtained. Data was collected using standard interviewrnquestions. For supplementing the quantitative results, 4 Focus group discussionsrnamong VCT users were conducted. To explain the study population in relation tornrelevant variables, frequencies and summary statistics were used. Associationrnbetween dependant and independent variable was assessed and presentedrnusing odds ratio and confidence interval. Logistic regression was used to controlrnpossible confounders.rnResult: Out of all 771 study participants, 14.5% were couples. The HIV infectionrnrate was 21%. Based on the adjusted regression, the respondents who were inrnthe primary education(1-8) level were four times likely to use CVCT service thanrnthose respondents who never had a formal education with AOR(95%CI): 3.88rn(1.22,12.30). Adjusted for the other variable, those study participants who usedrncondom occasionally, during sexual intercourse with their regular partners, werernfive times more likely to use CVCT service than those who never used condomsrnwith AOR (95%CI): 4.50 (1.33-15.31. Respondents who claimed to never heardrnixrnabout CVCT service utilization were less likely to use CVCT service compared tornthose who did with AOR (95%CI) 0.29(0.13-0.65).The participants who had nornhistory of HIV testing were less likely to use CVCT service than those who hadrnwith AOR (95%CI) 0.44(0.27-0.71).The knowledge of participants on HIV andrnother STIs had no significant association with CVCT service utilization. The mostrncommon reason claimed by the respondents for not using CVCT service duringrnthe study was because the partner already knew the result.rnConclusion and Recommendations: The prevalence of couples VCT servicernutilization in Addis Ababa VCT sites is low. Frequent, clear and accurate mediabasedrninformation programs using multiple languages are needed to increasernaccess to information on VCT, with particular attention to the importance of VCTrnfor couples. And other Specific approaches to promote CVCT service is neededrnto be developed service through appropriate researches.