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Timing Is Everything: International Variations in Historical Sexual Partnership Concurrency and HIV Prevalence

BACKGROUND: Higher prevalence of concurrent partnerships is one hypothesis for the severity of the HIV epidemic in the countries of Southern Africa. But measures of the prevalence of concurrency alone do not adequately capture the impact concurrency will have on transmission dynamics. The importance...

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Autores principales: Morris, Martina, Epstein, Helen, Wawer, Maria
Formato: Texto
Lenguaje:English
Publicado: Public Library of Science 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2991312/
https://www.ncbi.nlm.nih.gov/pubmed/21124829
http://dx.doi.org/10.1371/journal.pone.0014092
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author Morris, Martina
Epstein, Helen
Wawer, Maria
author_facet Morris, Martina
Epstein, Helen
Wawer, Maria
author_sort Morris, Martina
collection PubMed
description BACKGROUND: Higher prevalence of concurrent partnerships is one hypothesis for the severity of the HIV epidemic in the countries of Southern Africa. But measures of the prevalence of concurrency alone do not adequately capture the impact concurrency will have on transmission dynamics. The importance of overlap duration and coital exposure are examined here. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a comparison of data from three studies of sexual behavior carried out in the early 1990s in Uganda, Thailand and the US. Using cumulative concurrency measures, the three countries appeared somewhat similar. Over 50% of both Thai and Ugandan men reported a concurrency within the last three partnerships and over 20% reported a concurrency in the last year, the corresponding rates among US men were nearly 20% for Blacks and Hispanics, and about 10% for other racial/ethnic groups. Concurrency measures that were more sensitive to overlap duration, however, showed large differences. The point prevalence of concurrency on the day of interview was over 10% among Ugandan men compared to 1% for Thai men. Ugandan concurrencies were much longer duration – a median of about two years – than either the Thai (1 day) or US concurrencies (4–9 months across all groups), and involved 5–10 times more coital risk exposure with the less frequent partner. In the US, Blacks and Hispanics reported higher prevalence, longer duration and greater coital exposure than Whites, but were lower than Ugandans on nearly every measure. Together, the differences in the prevalence, duration and coital exposure of concurrent partnerships observed align with the HIV prevalence differentials seen in these populations at the time the data were collected. CONCLUSIONS/SIGNIFICANCE: There were substantial variations in the patterns of concurrent partnerships within and between populations. More long-term overlapping partnerships, with regular coital exposure, were found in populations with greater HIV epidemic severity.
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spelling pubmed-29913122010-12-01 Timing Is Everything: International Variations in Historical Sexual Partnership Concurrency and HIV Prevalence Morris, Martina Epstein, Helen Wawer, Maria PLoS One Research Article BACKGROUND: Higher prevalence of concurrent partnerships is one hypothesis for the severity of the HIV epidemic in the countries of Southern Africa. But measures of the prevalence of concurrency alone do not adequately capture the impact concurrency will have on transmission dynamics. The importance of overlap duration and coital exposure are examined here. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a comparison of data from three studies of sexual behavior carried out in the early 1990s in Uganda, Thailand and the US. Using cumulative concurrency measures, the three countries appeared somewhat similar. Over 50% of both Thai and Ugandan men reported a concurrency within the last three partnerships and over 20% reported a concurrency in the last year, the corresponding rates among US men were nearly 20% for Blacks and Hispanics, and about 10% for other racial/ethnic groups. Concurrency measures that were more sensitive to overlap duration, however, showed large differences. The point prevalence of concurrency on the day of interview was over 10% among Ugandan men compared to 1% for Thai men. Ugandan concurrencies were much longer duration – a median of about two years – than either the Thai (1 day) or US concurrencies (4–9 months across all groups), and involved 5–10 times more coital risk exposure with the less frequent partner. In the US, Blacks and Hispanics reported higher prevalence, longer duration and greater coital exposure than Whites, but were lower than Ugandans on nearly every measure. Together, the differences in the prevalence, duration and coital exposure of concurrent partnerships observed align with the HIV prevalence differentials seen in these populations at the time the data were collected. CONCLUSIONS/SIGNIFICANCE: There were substantial variations in the patterns of concurrent partnerships within and between populations. More long-term overlapping partnerships, with regular coital exposure, were found in populations with greater HIV epidemic severity. Public Library of Science 2010-11-24 /pmc/articles/PMC2991312/ /pubmed/21124829 http://dx.doi.org/10.1371/journal.pone.0014092 Text en Morris et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Morris, Martina
Epstein, Helen
Wawer, Maria
Timing Is Everything: International Variations in Historical Sexual Partnership Concurrency and HIV Prevalence
title Timing Is Everything: International Variations in Historical Sexual Partnership Concurrency and HIV Prevalence
title_full Timing Is Everything: International Variations in Historical Sexual Partnership Concurrency and HIV Prevalence
title_fullStr Timing Is Everything: International Variations in Historical Sexual Partnership Concurrency and HIV Prevalence
title_full_unstemmed Timing Is Everything: International Variations in Historical Sexual Partnership Concurrency and HIV Prevalence
title_short Timing Is Everything: International Variations in Historical Sexual Partnership Concurrency and HIV Prevalence
title_sort timing is everything: international variations in historical sexual partnership concurrency and hiv prevalence
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2991312/
https://www.ncbi.nlm.nih.gov/pubmed/21124829
http://dx.doi.org/10.1371/journal.pone.0014092
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