Abstract
Our objectives were to: (1) compare multiple measures of partnership concurrency, including the UNAIDS-recommended definition and (2) describe the prevalence and correlates of concurrent sexual partnerships among young Kenyan men. We analyzed 10,907 lifetime partnerships of 1,368 men ages 18-24 years enrolled in a randomized trial of male circumcision to reduce HIV-1 incidence in Kisumu. Partnership concurrency was determined by overlapping dates and examined over varying recall periods and assumptions. The lifetime prevalence of concurrency was 77 %. Sixty-one percent of all partnerships were concurrent and factors associated with concurrency differed by partner type. Point prevalence of concurrency at the time of the interview was consistently the highest and UNAIDS-recommended definition was the most conservative (25 vs. 18 % at baseline, respectively). Estimates of concurrency were influenced by methods for definition and measurement. Regardless of definition, concurrent partnerships are frequent in this population of young, sexually active men in high HIV prevalence Kisumu, Kenya.
Highlights
The significance of sexual partner concurrency in explaining the severity of the HIV epidemic in Sub-Saharan Africa is a subject of considerable debate [1,2,3,4,5,6,7,8]
We enrolled 1,393 of the 2,059 men who were screened for participation in the randomized control trial (RCT)
The small number (n = 8) of same-gender partnerships reported by four men precluded meaningful comparison and they were excluded from the analysis
Summary
The significance of sexual partner concurrency in explaining the severity of the HIV epidemic in Sub-Saharan Africa is a subject of considerable debate [1,2,3,4,5,6,7,8]. Mathematical models have consistently illustrated that compared to serial monogamy, concurrent partnerships increase the magnitude, spread, and persistence of the HIV epidemic [9,10,11]. % in 1998 to 8 % in 2003 in rural Zambian men [24]) Comparing such results, is difficult due to variation in the operational definitions and measurement methods used [4, 7]
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