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AIDS and Behavior
Published in: AIDS and Behavior 7/2013

01-09-2013 | Original Paper

Partnership Concurrency and Coital Frequency

Authors: Lauren Gaydosh, Georges Reniers, Stéphane Helleringer

Published in: AIDS and Behavior | Issue 7/2013

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Abstract

National HIV prevalence estimates across sub-Saharan Africa range from less than 1 percent to over 25 percent. Recent research proposes several explanations for the observed variation, including prevalence of male circumcision, levels of condom use, presence of other sexually transmitted infections, and practice of multiple concurrent partnerships. However, the importance of partnership concurrency for HIV transmission may depend on how it affects coital frequency with each partner. The coital dilution hypothesis suggests that coital frequency within a partnership declines with the addition of concurrent partners. Using sexual behavior data from rural Malawi and urban Kenya, we investigate the relationship between partnership concurrency and coital frequency, and find partial support for the coital dilution hypothesis. We conclude the paper with a discussion of our findings in light of the current literature on concurrency.
Appendix
Available only for authorised users
Footnotes
1
A study of the determinants of partnership concurrency using the ULYKP data finds that coital frequency of the initial relationship is not predictive of entry into a second, concurrent partnership [18].
 
2
We tested for a non-linear relationship with age, but the quadratic term was not significant. This specification of relationship duration is a restriction of the LNS data; the question asking about first sex in the LNS included response categories for within the last week, within the last month, within the last year, and more than 1 year ago. Inclusion of a linear and quadratic term for relationship duration in the ULYKP does not change the results.
 
3
12 % is for the ULYKP sample in Table 7.
 
4
The same relationship may also be reported on by both partners and thus included twice in the sample.
 
5
There is no mathematical requirement that levels of concurrency be the same for men and women. While the total number of sex acts must be the same (assuming only heterosexual sex), levels of concurrency may be different.
 
6
Results are of comparable magnitude and significance for spousal (formal) and non-spousal (informal) relationships in the LNS. For ULYKP, there is a negative but non-significant association between concurrency and coital frequency for spousal relationships. There is a positive but non-significant association between concurrency and coital frequency for non-spousal relationships. See Online Appendix 4 for results.
 
7
Even though the number of cases are not numerically important, it is worth noting that the UNAIDS definition forces us to right censor ongoing partnerships at the month of last sex if no sex was reported for the month before the survey.
 
8
We cannot repeat the analysis for the 3 years and 1 year preceding the survey because of the small number of relationship-months in which individuals have concurrent partners.
 
9
The assumption of a fixed number of partnerships implies that the number of men or women without a partner (i.e., the number of isolated nodes in a sexual network) increases as rates of partnership concurrency increase. In an empirical study of polygyny, for example, there is no evidence that young men’s access to sexual partners is restricted in populations with a higher prevalence of polygyny [17]. In other words, there is no evidence of an increase in the number of isolated nodes in populations where older polygynous men might be expected to crowd out the younger men from the partnerships market.
 
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Metadata
Title
Partnership Concurrency and Coital Frequency
Authors
Lauren Gaydosh
Georges Reniers
Stéphane Helleringer
Publication date
01-09-2013
Publisher
Springer US
Published in
AIDS and Behavior / Issue 7/2013
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-013-0525-x

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