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01-02-2010 | Commentary

Concurrent Partnerships as a Driver of the HIV Epidemic in Sub-Saharan Africa? The Evidence is Limited

Authors: Mark N. Lurie, Samantha Rosenthal

Published in: AIDS and Behavior | Issue 1/2010

Excerpt

Sub-Saharan Africa contains only 3% of the global population but an alarming 68% of the world’s adults and children living with HIV/AIDS (UNAIDS 2007). Sixty-eight percent of adults and children newly infected with HIV in 2007 also reside in this region (UNAIDS 2007). Although only 5% of adults are infected with HIV in Sub-Saharan Africa, no other region in the world has an HIV prevalence greater than 1% (UNAIDS 2007). There is also significant heterogeneity of HIV prevalence within sub-Saharan Africa with most countries in Southern Africa having an adult prevalence that exceeds 15% and some with adult prevalence as high as 27% (UNAIDS 2007). …

Aral, S. O. (1999). Sexual network patterns as determinants of STD rates: Paradigm shift in the behavioral epidemiology of STDs made visible. Sexually Transmitted Diseases, 26(5):262–264. doi:10.1097/00007435-199905000-00004.CrossRefPubMed

Boily, M. C., Baggaley, R. F., Wang, L., Masse, B., White, R. G., Hayes, R. J., et al. (2009). Heterosexual risk of HIV-1 infection per sexual act: Systematic review and meta-analysis of observational studies. The Lancet Infectious Diseases, 9(2):118–129. doi:10.1016/S1473-3099(09)70021-0.CrossRefPubMed

Carter, M. W., Kraft, J. M., Koppenhaver, T., Galavotti, C., Roels, T. H., Kilmarx, P. H., et al. (2007). “A bull cannot be contained in a single kraal”: Concurrent sexual partnerships in Botswana. AIDS and Behavior, 11:822–830. doi:10.1007/s10461-006-9203-6.CrossRefPubMed

Cleland, J., Boerma, J. T., Carael, M., & Weir, S. S. (2004). Monitoring sexual behavior in general populations: A synthesis of lessons of the past decade. Sexually Transmitted Infections, 80(Suppl. 2):1–7. doi:10.1136/sti.2004.013151.

Colvin, M., Abdool Karim, S. S., Connolly, C., Hoosen, A. A., & Ntuli, N. (1998). HIV infection and asymptomatic sexually transmitted infections in a rural South African community. International Journal of STD and AIDS, 9:548–550. doi:10.1258/0956462981922683.CrossRefPubMed

Deuchert, E., & Brody, S. (2007). Plausible and implausible parameters for mathematical modeling of nominal heterosexual HIV transmission. Annals of Epidemiology, 17:237–244. doi:10.1016/j.annepidem.2006.10.011.CrossRefPubMed

Doherty, I. A., Shiboski, S., Ellen, J. M., Adimora, A. A., & Padian, N. S. (2006). Sexual bridging socially and over time: A simulation model exploring the relative effects of mixing and concurrency on viral sexually transmitted infection transmission. Sexually Transmitted Diseases, 33(6):368–373. doi:10.1097/01.olq.0000194586.66409.7a.CrossRefPubMed

Epstein, H. (2007). The invisible cure. Why we are losing the fight against AIDS in Africa. New York: Picador.

Epstein, H. (2008). AIDS and the irrational. British Medical Journal, 337:1265–1267. doi:10.1136/bmj.a2638.CrossRef

Garnett, G. P., & Johnson, A. M. (1997). Coining a new term in epidemiology: Concurrency and HIV. AIDS (London, England), 11:681–683. doi:10.1097/00002030-199705000-00017.

Ghani, A. C., & Garnett, G. P. (2000). Risks of acquiring and transmitting sexually transmitted diseases in sexual partner networks. Sexually Transmitted Diseases, 27(10):579–587. doi:10.1097/00007435-200011000-00006.CrossRefPubMed

Halperin, D., & Epstein, H. (2004). Concurrent sexual partnerships help to explain Africa’s high HIV prevalence: Implications for prevention. Lancet, 364(9428):4–6. doi:10.1016/S0140-6736(04)16606-3.CrossRefPubMed

Harrison, A., Cleland, J., & Frohlich, J. (2008). Young people’s sexual partnerships in KwaZulu/Natal, South Africa: Patterns, contextual influences, and HIV risk. Studies in Family Planning, 39(4):295–308. doi:10.1111/j.1728-4465.2008.00176.x.CrossRefPubMed

Helleringer, S., & Kohler, H.-P. (2007). Sexual network structure and the spread of HIV in Africa: Evidence from Likoma Island, Malawi. AIDS (London, England), 21(17):2323–2332. doi:10.1097/QAD.0b013e328285df98.

Hill, A. B. (1971). Statistical evidence and inference. Principles of medical statistics (9th ed.) (pp. 309–323). New York: Oxford University Press.

Hollingsworth, T. D., Anderson, R. M., & Fraser, C. (2008). HIV-1 transmission, by stage of infection. The Journal of Infectious Diseases, 198(5):687–693. doi:10.1086/590501.CrossRefPubMed

Hudson, C. P. (1993). Concurrent partnerships could cause AIDS epidemics. International Journal of STD and AIDS, 4(5):249–253.PubMed

Jewkes, R., Dunkle, K., Nduna, M., Levin, J., Jama, N., Khuzwayo, N., et al. (2006). Factors associated with HIV sero-positivity in young, rural South African men. International Journal of Epidemiology, 35(6):1455–1460. doi:10.1093/ije/dyl217.CrossRefPubMed

Kalichman, S. C., Ntseane, D., Nthomang, K., Segwabe, M., Phorano, O., & Simbayi, L. C. (2007). Recent multiple sexual partners and HIV transmission risks among people living with HIV/AIDS in Botswana. Sexually Transmitted Infections, 83:371–375. doi:10.1136/sti.2006.023630.CrossRefPubMed

Korenromp, E. L., van Vliet, C., Bakker, R., de Vlas, S. J., & Habbema, J. D. F. (2000). HIV spread and partnership reduction for different patterns of sexual behaviour—a study with the microsimulation model STDSIM. Mathematical Population Studies, 8(2):135–173.CrossRef

Kretzschmar, M., & Morris, M. (1996). Measures of concurrency in networks and the spread of infectious diseases. Mathematical Biosciences, 133:165–195. doi:10.1016/0025-5564(95)00093-3.CrossRefPubMed

Lagarde, E., Auvert, B., et al. (2001). Concurrent sexual partnerships and HIV prevalence in five urban communities of Sub-Saharan Africa. AIDS (London, England), 15(7):877–884. doi:10.1097/00002030-200105040-00008.

Leynaert, B., Downs, A., de Vincenzi, I., et al. (1998). Heterosexual transmission of human immunodeficiency virus: Variability of infectivity throughout the course of infection. American Journal of Epidemiology, 148(1):88–96.PubMed

Lurie, M., Williams, B., Zuma, K., et al. (2003). The impact of migration on HIV-1 transmission: A study of migrant and non-migrant men, and their partners. Sexually Transmitted Diseases, 40(2):149–156. doi:10.1097/00007435-200302000-00011.CrossRef

Mah, T. L., & Halperin, D. T. (2008). Concurrent sexual partnerships and the HIV epidemics in Africa: Evidence to move forward. AIDS and Behavior, 22. Epub ahead of print.

Mattson, C. L., Bailey, R. C., Agot, K., Ndinya-Achola, J. O., & Moses, S. (2007). A nested case-control study of sexual practices and risk factors for prevalent HIV-1 infection among young men in Kisumu, Kenya. Sexually Transmitted Diseases, 34(10):731–736.PubMed

Mishra, V., & Assche, S. B.-V. (2009). Concurrent sexual partnerships and HIV infection: Evidence from national population-based surveys. DHS Working Paper 62. Accessed at http://www.measuredhs.com/pubs/pdf/WP62/WP62.pdf on May 5, 2009.

Mitsunaga, T. M., Powell, A. M., Heardm, N. J., & Larsen, U. M. (2005). Extramarital sex among Nigerian men” polygyny and other risk factors. Journal of Acquired Immune Deficiency Syndromes, 39(4):478–488. doi:10.1097/01.qai.0000152396.60014.69.CrossRefPubMed

Morris, M., & Kretzschmar, M. (1997). Concurrent partnerships and the spread of HIV. AIDS (London, England), 11:641–648. doi:10.1097/00002030-199705000-00012.

Morris, M., & Kretzschmar, M. (2000). A microsimulation study of the effect of concurrent partnerships on the spread of HIV in Uganda. Mathematical Population Studies, 8(2):109–133.CrossRef

Nelson, S. J., Manhart, L. E., Gorbach, P. M., et al. (2007). Measuring sex partner concurrency: It’s what’s missing that counts. Sexually Transmitted Diseases, 34(10):801–807. doi:10.1007/978-1-59745-040-9.PubMed

Pettifor, A. E., Rees, H. V., Kleinschmidt, I., et al. (2005). Young people’s sexual health in South Africa: HIV prevalence and sexual behaviors from a nationally representative household survey. AIDS (London, England), 19:1525–1534. doi:10.1097/01.aids.0000183129.16830.06.

Piot, P., Greener, R., & Russell, S. (2007). Squaring the circle: AIDS, poverty and human development. PLoS Medicine, 4(10):1571–1575. doi:10.1371/journal.pmed.0040314.CrossRefPubMed

Sandoy, I. F., Dzekedzeke, K., & Fylkesnes, K. (2008). Prevalence and correlates of concurrent sexual partnerships in Zambia. AIDS and Behavior, 8. Epub ahead of print.

UNAIDS. (2003). AIDS epidemic update: December 2003. Geneva: UNAIDS.

UNAIDS. (2007). AIDS epidemic update: December 2007. Geneva: UNAIDS.

van der Ploeg, C. P. B., van Vliet, D., de Vlas, S. J., Ndinya-Achola, J. O., Fransen, L., et al. (1988). STDSIM: A microsimulation model for decision support on STD control. Interfaces, 28:84–100. doi:10.1287/inte.28.3.84.CrossRef

Wasserheit, J. N. (1992). Epidemiological synergy: Interrelationships Between Human Immunodeficiency Virus Infection and other Sexually Transmitted Diseases. Sexually Transmitted Diseases, 19(2):61–77. doi:10.1097/00007435-199219020-00001.PubMed

Watts, C. H., & May, R. M. (1992). The influence of concurrent partnerships on the dynamics of HIV/AIDS. Mathematical Biosciences, 108(1):89–104. doi:10.1016/0025-5564(92)90006-I.CrossRefPubMed

Wellings, K., Collumbien, M., Slaymaker, E., et al. (2006). Sexual behavior in context: A global perspective. Lancet, 368:1706–1728. doi:10.1016/S0140-6736(06)69479-8.CrossRefPubMed

Wellings, K., Slaymaker, E., Bajos, N., Collumbien, M., & Singh, S. (2007). Global sexual behavior. Lancet, 369(9561):557. doi:10.1016/S0140-6736(07)60270-0. author reply 557.CrossRef

Williams, B. G., Lloyd-Smith, J. O., Gouws, E., Hankins, C., & Getz, W. M. (2006). The potential impact of male circumcision on HIV in Sub-Saharan Africa. PLoS Medicine, 3(7):e262. doi:10.1371/journal.pmed.0030262.CrossRefPubMed

Title: Concurrent Partnerships as a Driver of the HIV Epidemic in Sub-Saharan Africa? The Evidence is Limited
Authors: Mark N. Lurie
Samantha Rosenthal
Publication date: 01-02-2010
Publisher: Springer US
Published in: AIDS and Behavior / Issue 1/2010
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI: https://doi.org/10.1007/s10461-009-9583-5

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