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

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

doi:10.1186/s12981-016-0098-7

Zakir Gaffoor, Handan Wand + Show 3 more

Open Access

https://doi.org/10.1186/s12981-016-0098-7

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Abstract

BackgroundWomen 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.MethodsSocio-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.ResultsThe 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.ConclusionsThe 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.

Highlights

Women in sub-Saharan Africa continue to be at greater risk for Human Immuno-Deficiency Virus (HIV) acquisition than men
Significant associations were noted between perceived male partner concurrency and women’s age, partner age, women’s individual concurrency status, marital status, economic abuse, partner circumcision status, women changing partners during the study, condom use, contraception use and being diagnosed with an Sexually Transmitted Infection (STI) at screening
We examined the association between male partner concurrency and HIV and STI incidence (Figs. 1, 2; Table 3)

Summary

Introduction

Women in sub-Saharan Africa continue to be at greater risk for HIV acquisition than men. In 2012, an estimated 35.3 million people were living with HIV/AIDS, with 2.3 million new infections reported globally [1]. A broad range of factors contribute to women in this region being at a greater risk for HIV acquisition when compared to men. These include established gender inequalities, gender-based violence, and lack of access to proven preventative and treatment options, in addition to behavioural and biological risk factors [1]. An important risk factor for HIV infection is multiple sexual partnerships, and programmes that aim to reduce the number of partners have proven effective in some settings [2].

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