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Published in: AIDS Research and Therapy 1/2016

Open Access 01-12-2016 | Research

Predictors of perceived male partner concurrency among women at risk for HIV and STI acquisition in Durban, South Africa

Authors: Zakir Gaffoor, Handan Wand, Renée A. Street, Nathlee Abbai, Gita Ramjee

Published in: AIDS Research and Therapy | Issue 1/2016

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Abstract

Background

Women in sub-Saharan Africa continue to be at greater risk for HIV acquisition than men. Concurrency, viz. multiple sexual partnerships that overlap over time, has been studied as a possible risk factor for HIV transmission. The aim of this study was to identify predictors of perceived male partner concurrency among sexually active, HIV negative women.

Methods

Socio-demographic and behavioural data from women enrolled in a biomedical HIV prevention clinical trial were assessed in relation to perceived male partner concurrency using the Chi squared test. Univariate and multivariate logistic regression was performed to assess the independent predictors of perceived male partner concurrency. Kaplan–Meier survival estimates were obtained for HIV and STI incidence in relation to male partner concurrency. A Cox Proportional Hazards model was used to assess the association between perceived male partner concurrency and HIV and STI incidence.

Results

The results revealed that 29 % of women reported their male partners to be in concurrent sexual relationships, 22 % reported partners that were not engaging in concurrency, whilst 49 % reported not knowing their partners concurrency status. Older women, having never married, experiencing economic abuse, and women reporting individual concurrency, were found to be significant predictors of perceived male partner concurrency in the studied population. Perceived male partner concurrency was not found to be a significantly associated with incident HIV and STI infections in this analysis.

Conclusions

The study provides insight into predictors of perceived male partner concurrency among women at high risk for STI and HIV acquisition. These results may inform the design of behavioural and biomedical interventions, to address the role of multiple sexual partnerships in HIV prevention.
Literature
2.
go back to reference Mah TL, Halperin DT. Concurrent sexual partnerships and the HIV epidemics in Africa: evidence to move forward. AIDS Behav. 2010;14:11–6.CrossRefPubMed Mah TL, Halperin DT. Concurrent sexual partnerships and the HIV epidemics in Africa: evidence to move forward. AIDS Behav. 2010;14:11–6.CrossRefPubMed
3.
go back to reference UNAIDS Reference Group on Estimates. Modelling, projections: working group on measuring concurrent sexual partnerships. hiv: consensus indicators are needed for concurrency. Lancet. 2010;375:621–2.CrossRef UNAIDS Reference Group on Estimates. Modelling, projections: working group on measuring concurrent sexual partnerships. hiv: consensus indicators are needed for concurrency. Lancet. 2010;375:621–2.CrossRef
4.
5.
go back to reference Tanser F, Bärnighausen T, Hund L, Garnett GP, McGrath N, Newell ML. Effect of concurrent sexual partnerships on rate of new HIV infections in a high-prevalence, rural South African population: a cohort study. Lancet. 2011;378:247–55.CrossRefPubMedPubMedCentral Tanser F, Bärnighausen T, Hund L, Garnett GP, McGrath N, Newell ML. Effect of concurrent sexual partnerships on rate of new HIV infections in a high-prevalence, rural South African population: a cohort study. Lancet. 2011;378:247–55.CrossRefPubMedPubMedCentral
6.
go back to reference Lurie MN, Rosenthal S. Concurrent partnerships as a driver of the HIV epidemic in sub-Saharan Africa? The evidence is limited. AIDS Behav. 2010;14:17–24.CrossRefPubMed Lurie MN, Rosenthal S. Concurrent partnerships as a driver of the HIV epidemic in sub-Saharan Africa? The evidence is limited. AIDS Behav. 2010;14:17–24.CrossRefPubMed
8.
go back to reference Eaton JW, Hallett TB, Garnett GP. Concurrent sexual partnerships and primary HIV infection: a critical interaction. AIDS Behav. 2010;15:687–92.CrossRef Eaton JW, Hallett TB, Garnett GP. Concurrent sexual partnerships and primary HIV infection: a critical interaction. AIDS Behav. 2010;15:687–92.CrossRef
9.
go back to reference Morris M. Barking up the wrong evidence tree. Comment on Lurie and Rosenthal, ‘‘Concurrent partnerships as a driver of the HIV epidemic in sub-Saharan Africa? The evidence is limited’’. AIDS Behav. 2010;14:31–3.CrossRefPubMedPubMedCentral Morris M. Barking up the wrong evidence tree. Comment on Lurie and Rosenthal, ‘‘Concurrent partnerships as a driver of the HIV epidemic in sub-Saharan Africa? The evidence is limited’’. AIDS Behav. 2010;14:31–3.CrossRefPubMedPubMedCentral
10.
go back to reference Maher D, Waswa L, Karabarinde A, Baisley K. Concurrent sexual partnerships and associated factors: a cross-sectional population-based survey in a rural community in Africa with a generalised HIV epidemic. BMC Public Health. 2011;11:651.CrossRefPubMedPubMedCentral Maher D, Waswa L, Karabarinde A, Baisley K. Concurrent sexual partnerships and associated factors: a cross-sectional population-based survey in a rural community in Africa with a generalised HIV epidemic. BMC Public Health. 2011;11:651.CrossRefPubMedPubMedCentral
11.
go back to reference Skoler-Karpoff S, Ramjee G, Ahmed K, Altini L, Plagianos MG, Friedland B, Govender S, De Kock A, Cassim N, Palanee T, Dozier G, Maguire R, Lahteenmaki P. Efficacy of Carraguard for prevention of HIV infection in women in South Africa: a randomised, double-blind, placebo-controlled trial. Lancet. 2008;372(9654):1977–87.CrossRefPubMed Skoler-Karpoff S, Ramjee G, Ahmed K, Altini L, Plagianos MG, Friedland B, Govender S, De Kock A, Cassim N, Palanee T, Dozier G, Maguire R, Lahteenmaki P. Efficacy of Carraguard for prevention of HIV infection in women in South Africa: a randomised, double-blind, placebo-controlled trial. Lancet. 2008;372(9654):1977–87.CrossRefPubMed
12.
go back to reference Kenyon C, Colebunders R. Strong association between point-concurrency and national peak HIV prevalence. Int J Infect Dis. 2012;16:e826–7.CrossRefPubMed Kenyon C, Colebunders R. Strong association between point-concurrency and national peak HIV prevalence. Int J Infect Dis. 2012;16:e826–7.CrossRefPubMed
13.
go back to reference Gray R, Ssempiija V, Shelton J, Serwadda D, Nalugoda F, Kagaayi J, Kigozi G, Wawer MJ. The contribution of HIV-discordant relationships to new HIV infections in Rakai, Uganda. AIDS. 2011;25(6):863–5.CrossRefPubMedPubMedCentral Gray R, Ssempiija V, Shelton J, Serwadda D, Nalugoda F, Kagaayi J, Kigozi G, Wawer MJ. The contribution of HIV-discordant relationships to new HIV infections in Rakai, Uganda. AIDS. 2011;25(6):863–5.CrossRefPubMedPubMedCentral
14.
go back to reference Xu HW, Luke N, Zulu EM. Concurrent sexual partnerships among youth in urban Kenya: prevalence and partnership effects. Pop Stud J Demog. 2010;64:247–61.CrossRef Xu HW, Luke N, Zulu EM. Concurrent sexual partnerships among youth in urban Kenya: prevalence and partnership effects. Pop Stud J Demog. 2010;64:247–61.CrossRef
15.
16.
go back to reference Drumright LN, Gorbach PM, Holmes KK. Do people really know their sex partners? Concurrency, knowledge of partner behavior, and sexually transmitted infections within partnerships. Sex Transm Dis. 2004;31(7):437–42.CrossRefPubMed Drumright LN, Gorbach PM, Holmes KK. Do people really know their sex partners? Concurrency, knowledge of partner behavior, and sexually transmitted infections within partnerships. Sex Transm Dis. 2004;31(7):437–42.CrossRefPubMed
17.
go back to reference Nnko S, Boerma JT, Urassa M, Mwaluko G, Zaba B. Secretive females or swaggering males? An assessment of the quality of sexual partnership reporting in rural Tanzania. Soc Sci Med. 2004;59(2):299–310.CrossRefPubMed Nnko S, Boerma JT, Urassa M, Mwaluko G, Zaba B. Secretive females or swaggering males? An assessment of the quality of sexual partnership reporting in rural Tanzania. Soc Sci Med. 2004;59(2):299–310.CrossRefPubMed
18.
go back to reference Lenoir CD, Adler NE, Borzekowski DL, Tschann JM, Ellen JM. What you don’t know can hurt you: perceptions of sex-partner concurrency and partner-reported behavior. J Adolesc Health. 2006;38(3):179–85.CrossRefPubMed Lenoir CD, Adler NE, Borzekowski DL, Tschann JM, Ellen JM. What you don’t know can hurt you: perceptions of sex-partner concurrency and partner-reported behavior. J Adolesc Health. 2006;38(3):179–85.CrossRefPubMed
19.
go back to reference Steffenson AE, Pettifor AE, Seage GR 3rd, Rees HV, Cleary PD. Concurrent sexual partnerships and human immunodeficiency virus risk among South African youth. Sex Transm Dis. 2011;38(6):459–66.PubMedPubMedCentral Steffenson AE, Pettifor AE, Seage GR 3rd, Rees HV, Cleary PD. Concurrent sexual partnerships and human immunodeficiency virus risk among South African youth. Sex Transm Dis. 2011;38(6):459–66.PubMedPubMedCentral
20.
go back to reference Maughan-Brown B. Concurrent sexual partnerships among young adults in Cape Town, South Africa: how is concurrency changing? Sex Health. 2013;10(3):246–52.PubMed Maughan-Brown B. Concurrent sexual partnerships among young adults in Cape Town, South Africa: how is concurrency changing? Sex Health. 2013;10(3):246–52.PubMed
21.
go back to reference Kenyon C, Boulle A, Badri M, Asselman V. I don’t use a condom (with my regular partner) because I know that I’m faithful, but with everyone else I do: the cultural and socioeconomic determinants of sexual partner concurrency in young South Africans. Sahara J. 2010;7(3):35–43.CrossRefPubMed Kenyon C, Boulle A, Badri M, Asselman V. I don’t use a condom (with my regular partner) because I know that I’m faithful, but with everyone else I do: the cultural and socioeconomic determinants of sexual partner concurrency in young South Africans. Sahara J. 2010;7(3):35–43.CrossRefPubMed
22.
go back to reference Townsend L, Jewkes R, Mathews C, Johnston LG, Flisher AJ, Zembe Y, Chopra M. HIV risk behaviours and their relationship to intimate partner violence (IPV) among men who have multiple female sexual partners in Cape Town. South Africa. AIDS Behav. 2011;15(1):132–41.CrossRefPubMed Townsend L, Jewkes R, Mathews C, Johnston LG, Flisher AJ, Zembe Y, Chopra M. HIV risk behaviours and their relationship to intimate partner violence (IPV) among men who have multiple female sexual partners in Cape Town. South Africa. AIDS Behav. 2011;15(1):132–41.CrossRefPubMed
23.
go back to reference Delva W, Meng F, Beauclair R, Deprez N, Temmerman M, Welte A, Hens N. Coital frequency and condom use in monogamous and concurrent sexual relationships in Cape Town, South Africa. J Int AIDS Soc. 2013;16:18034.PubMedPubMedCentral Delva W, Meng F, Beauclair R, Deprez N, Temmerman M, Welte A, Hens N. Coital frequency and condom use in monogamous and concurrent sexual relationships in Cape Town, South Africa. J Int AIDS Soc. 2013;16:18034.PubMedPubMedCentral
24.
go back to reference Macaluso M, Demand MJ, Artz LM, Hook EW 3rd. Partner type and condom use. AIDS. 2000;14(5):537–46.CrossRefPubMed Macaluso M, Demand MJ, Artz LM, Hook EW 3rd. Partner type and condom use. AIDS. 2000;14(5):537–46.CrossRefPubMed
25.
go back to reference Westercamp N, Mattson CL, Madonia M, Moses S, Agot K, Ndinya-Achola JO, Otieno E, Ouma N, Bailey RC. Determinants of consistent condom use vary by partner type among young men in Kisumu, Kenya: a multi-level data analysis. AIDS Behav. 2010;14(4):949–59.CrossRefPubMedPubMedCentral Westercamp N, Mattson CL, Madonia M, Moses S, Agot K, Ndinya-Achola JO, Otieno E, Ouma N, Bailey RC. Determinants of consistent condom use vary by partner type among young men in Kisumu, Kenya: a multi-level data analysis. AIDS Behav. 2010;14(4):949–59.CrossRefPubMedPubMedCentral
26.
go back to reference Wand H, Ramjee G. Combined impact of sexual risk behaviors for HIV seroconversion among women in Durban, South Africa: implications for prevention policy and planning. AIDS Behav. 2011;15(Suppl 2):479–86.CrossRefPubMed Wand H, Ramjee G. Combined impact of sexual risk behaviors for HIV seroconversion among women in Durban, South Africa: implications for prevention policy and planning. AIDS Behav. 2011;15(Suppl 2):479–86.CrossRefPubMed
27.
go back to reference Gaffoor Z, Wand H, Daniels B, Ramjee G. High risk sexual behaviors are associated with sexual violence among a cohort of women in Durban, South Africa. BMC Res Notes. 2013;6:532.CrossRefPubMedPubMedCentral Gaffoor Z, Wand H, Daniels B, Ramjee G. High risk sexual behaviors are associated with sexual violence among a cohort of women in Durban, South Africa. BMC Res Notes. 2013;6:532.CrossRefPubMedPubMedCentral
29.
go back to reference Gray RH, Wawer MJ. Reassessing the hypothesis on STI control for HIV prevention. Lancet. 2008;371(9630):2064–5.CrossRefPubMed Gray RH, Wawer MJ. Reassessing the hypothesis on STI control for HIV prevention. Lancet. 2008;371(9630):2064–5.CrossRefPubMed
Metadata
Title
Predictors of perceived male partner concurrency among women at risk for HIV and STI acquisition in Durban, South Africa
Authors
Zakir Gaffoor
Handan Wand
Renée A. Street
Nathlee Abbai
Gita Ramjee
Publication date
01-12-2016
Publisher
BioMed Central
Published in
AIDS Research and Therapy / Issue 1/2016
Electronic ISSN: 1742-6405
DOI
https://doi.org/10.1186/s12981-016-0098-7

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