Extramarital Partners Research Articles

P4.004 Actor and Partner Effects of Relationship and Sexual Satisfaction on Extra-Marital Partnerships Among Married Couples in Fishing Communities on Lake Victoria in Kisumu County, Kenya

BackgroundExtra-marital partnerships have been associated with the spread of STIs including HIV among married couples. We sought to establish the actor and partner effects of relationship and sexual satisfactions on...

P4.060 Accuracy and Correlates of Infidelity Suspicions Among Married Couples in the Fishing Communities on Lake Victoria in Kisumu County, Kenya

BackgroundInaccurate suspicions of infidelity among married couples can affect trust and intimacy in a relationship. We sought to establish the prevalence, accuracy and correlates of infidelity suspicions among married couples.Methods...

Have the educated changed HIV risk behaviours more in Africa?

Theory predicts that when new health information becomes available, more educated individuals may adopt healthy behaviours sooner, resulting in lower morbidity and mortality among the highly educated. This may be the case for HIV in sub-Saharan Africa: Recent empirical work shows that incidence is falling and the reduction is concentrated in more educated populations. However, it is unclear whether the educated have indeed adopted HIV risk-reducing behaviours to a greater extent than the less educated. I used two rounds of demographic and health surveys (DHS) in eight African countries to examine whether HIV-related behavioural change over time is greater among the more highly educated. I examined changes in condom use, age of marriage, number of partners, extramarital partnerships, and HIV testing. Results showed that education has a robust positive association with condom use and HIV testing, but also with having more sexual partners. I found that the probability of HIV testing increased more between rounds among the more educated, relative to the less educated. More educated men also appeared to have larger reductions in the number of sexual partners and there was evidence that younger, more educated women may be marrying earlier than their predecessors did. The education gradient did not change significantly over time for condom use. These changes in behaviour may signal a shift in the future burden of the epidemic towards more marginalised and less educated populations.

Have the Educated Changed HIV Risk Behaviors More in Africa?

Theory predicts that when new health information becomes available, more educated individuals may adopt healthy behaviors sooner, resulting in lower morbidity and mortality among the highly educated. This may be the case for HIV in sub-Saharan Africa: Recent empirical work shows that incidence is falling and the reduction is concentrated in more educated populations. However, it is unclear whether the educated have indeed adopted HIV risk-reducing behaviors to a greater extent than the less educated. I use two rounds of Demographic and Health surveys in eight African countries to examine whether HIV-related behavioral change over time is greater among the more highly educated. I examine changes in condom use, age of marriage, number of partners, extra-marital partnerships, and HIV testing. I find that education has a robust positive association with condom use and HIV testing, but also with having more sexual partners. I find that the probability of HIV testing increased more between rounds among the more educated, relative to the less educated. More educated men also appear to have larger reductions in the number of sexual partners and there is evidence that younger, more educated women may be marrying earlier than their predecessors did. The education gradient does not change significantly over time for condom use. These changes in behavior may signal a shift of the future burden of the epidemic towards more marginalized and less educated populations.

AN ASSOCIATION BETWEEN ETHNIC DIVERSITY AND HIV PREVALENCE IN SUB-SAHARAN AFRICA

This paper investigates whether ethnic diversity at the Demographic and Health Surveys (DHS) cluster level predicts HIV serostatus in three sub-Saharan African countries (Kenya, Malawi and Zambia), using DHS household survey and HIV biomarker data for men and women aged 15–59 collected since 2006. The analysis relates a binary dependent variable (HIV positive serostatus) and a weighted aggregate predictor variable representing the number of different ethnic groups within a DHS Statistical Enumeration Area (SEA) or cluster, which roughly corresponds to a neighbourhood. Multilevel logistic regression is used to predict HIV prevalence within each SEA, controlling for known demographic, social and behavioural predictors of HIV serostatus. The key finding was that the cluster-level ethnic diversity measure was a significant predictor of HIV serostatus in Malawi and Zambia but not in Kenya. Additional results reflected the heterogeneity of the epidemics: male gender, marriage (Kenya), number of extramarital partners in the past year (Kenya and Malawi, but probably confounded with younger age) and Muslim religion (Zambia) were associated with lower odds of positive HIV serostatus. Condom use at last intercourse (a spurious result probably reflecting endogeneity), STD in the past year, number of lifetime sexual partners, age (Malawi and Zambia), education (Zambia), urban residence (Malawi and Zambia) and employment (Kenya and Malawi) were associated with higher odds of positive serostatus. Future studies might continue to employ multilevel models and incorporate additional, more robust, controls for individual behavioural risk factors and for higher-level social and economic factors, in order to verify and further clarify the association between neighbourhood ethnic diversity and HIV serostatus.

The Vashti Paradigm Resistance as a Strategy for Combating HIV

The Vashti Paradigm Resistance as a Strategy for Combating <scp>HIV</scp>

LEGAL MATRIMONIAL REGIME IN B&amp;H

Matrimonial regime between spouses or between extramarital partners and between parents an children is regulated by Family Law Act of Bosnia and Herzegovina.

Midlife Sexuality Among Thai Adults: Adjustment to Aging in the Thai Family Context

The objective of the study is to assess views of age related changes in sexual behavior among married Thai adults age 53 to 57. Results are viewed in the context of life course theory. In-depth interviews were conducted with 44 Thai adults in Bangkok and the four regions of Thailand. Topics covered include changing sexual behavior with age, adjustment to this change, gender differences in behavior, attitudes toward commercial sex and other non-marital sexual partners, and condom use. Most respondents were aware of this change and saw a decrease in sexual activity and desire more often among women compared to men. At the same time, many respondents viewed sexuality as important to a marriage. Some respondents accepted the decrease in sexual activity and focused more on work, family and temple activities. Thai Buddhism was seen as an important resource for people who were dealing with changes due to aging. Other persons turned to other partners including both commercial and non-commercial partners. The influence of the HIV epidemic that began in the 1990s was seen in concerns about disease transmission with extramarital partners and consequent attitudes toward condom use. The acceptability of extramarital partners in the family and community ranged from acceptance to strong disapproval of extramarital relationships.

P1-S5.19 Marriage dissolution and HIV prevalence in rural Zimbabwe 2003-2008

<h3>Background</h3> Over the past decade, HIV prevalence in Zimbabwe has significantly declined, with recent research attributing this decline to wide-spread behaviour change such as reductions in extramarital sexual partnerships. Despite these reductions in risky sexual Behaviours, infections could still be transmitted from one marital union to another as divorced or widowed HIV-positive persons remarry. <h3>Methods</h3> Using information collected through face-to-face interviews in 2003–2005 AND 2006–2008, we compared HIV prevalence and basic demographics among women and their spouses (married, or in a long-term or cohabiting relationship for &gt;12 months) in Manicaland, Zimbabwe. We used logistic regression to assess differences in marital history and basic demographics between HIV seronegative concordant couples, HIV serodiscordant couples and HIV seropositive concordant couples. <h3>Results</h3> In nearly one-third of the 2836 (27.8%) of marital unions interviewed, at least one member was infected with HIV (n=787); both members were HIV positive in 372 couples (13%). Of the 415 serodiscordant couples, 157 (5.5%) were serodiscordant female positive. Overall, compared to those in seronegative concordant (NC) partnerships, women in female-positive discordant (FP) or seropositive concordant (PC) partnerships were older (25–34 years vs 15–24; OR 1.7, 95% CI 1.17 to 2.47; OR 3.35, 2.52 to 4.45, respectively), more likely to been divorced (FP OR 4.19, 2.83 to 6.20; PC OR 4.12, 3.10 to 5.48), and more likely to have been widowed (FP OR 7.83, 3.65 to 16.76; PC OR 7.86, 4.30 to 14.36). Similar but weaker trends in divorce/widowhood were observed among men in male-positive discordant relationships compared to men in SN relationships. Women in FP and PC partnerships both were nearly three times as likely to report &gt;1 lifetime sex partners than women in SN partnerships (FP OR 2.82, 2.02 to 3.92; PC OR 2.86, 2.27 to 3.59); mean lifetime sex partners reported by women in FP and PC partnerships was similar (FP: 2.11 lifetime partners; PC 2.06). <h3>Conclusions</h3> HIV prevalence is high among persons in long-term, stable partnerships, and strongly associated with one or both partners reporting a history of divorce or being widowed. In particular, widowed and divorced women may play an important role in ongoing HIV transmission dynamics. VCT services and other interventions that target couples should be promoted among divorced and widowed individuals.

P1-S1.22 HSV-2 prevalence across a pastoral landscape: transmission and transition among the Himba and Tjimba populations

BackgroundSexual partnerships take multiple forms among the Himba and Tjimba people living in Northwestern Namibia, including polygynous and monogamous marriage, and long- and short-term extra-marital partnerships. We hypothesised that HSV-2...

P2-S3.09 Mobility as predictor of involvemnet in high risk sexual risk behaviour

BackgroundPopulation mobility has long been associated with frequency and variety of sexually transmitted infections including HIV. People's mobility tends to disrupt their traditional social constraints and control of sexual behaviour...

The contribution of HIV-discordant relationships to new HIV infections: a rebuttal

This letter responds to the previous letter about HIV discordant couples and their role in the HIV epidemic. The authors here state that the HIV discordant couples have been misclassified. Instead the HIV couples should be regarded as couples who voluntarily sought out counseling and testing. These couples indicate high interest in condition disclosure and counseling. This population does not include individuals who resisted testing disclosure or counseling. Thus this report cannot and does not attempt to discuss HIV-discordant couples who refrain from being identified.

Health Costs of Wealth Gains: Labor Migration and Perceptions of HIV/AIDS Risks in Mozambique

The study employs survey data from rural Mozambique to examine how men's labor migration affects their non-migrating wives' perceptions of HIV/AIDS risks. Using a conceptual framework centered on tradeoffs between economic security and health risks that men's migration entails for their left-behind wives, it compares women married to migrants and those married to non-migrants while also distinguishing between economically successful and unsuccessful migration. The analysis finds that the economic success of men's migration, rather than migration itself, significantly predicts women's worries about getting infected by their husbands or their own extramarital partners, and their husbands' stance on condom use. These findings are situated within a broader context of socio-economic, gender, and marital dynamics and vulnerabilities produced or amplified by male labor migration in sub-Saharan and similar developing settings.

Disclosure of HIV status between spouses in rural Malawi

Disclosure of HIV status after HIV voluntary counseling and testing has important implications for the spread of the HIV epidemic and the health of individuals who are HIV positive. Here, we use individual and couples level data for currently married respondents from an ongoing longitudinal study in rural Malawi to (1) examine the extent of HIV status disclosure by HIV serostatus; (2) identify reasons for not sharing one's HIV status with a spouse; and (3) evaluate the reliability of self-reports of HIV status disclosure. We find that disclosure of HIV status is relatively common among rural Malawians, where most have shared their status with a spouse, and many disclose to others in the community. However, there are significant differences in disclosure patterns by HIV status and gender. Factors associated with non-disclosure are also gendered, where women who perceive greater HIV/AIDS stigma and HIV positive are less likely to disclose HIV status to a spouse, and men who are worried about HIV infection from extramarital partners are less likely to disclose their HIV status to a spouse. Finally, we test the reliability of self-reported HIV status disclosure and find that self-reports of HIV-positive men are of questionable reliability.

Variations in Condom Use by Type of Partner in 13 Sub‐Saharan African Countries

Using nationally representative data from 13 sub-Saharan African countries, we reinforce and expand upon previous findings that men report using condoms more frequently than women do and that unmarried respondents report that they use condoms with casual partners more frequently than married individuals report using them with their spouses. Based on descriptive, bivariate, and multivariate analyses, we also demonstrate to a degree not previously shown in the current literature that married men from most countries report using condoms with extramarital partners about as frequently as unmarried men report using them with casual partners. Married women from most of the countries included in the study reported using condoms with extramarital partners less frequently than unmarried women reported using them with casual partners. This result is especially troubling because marriage usually ensures regular sexual intercourse, thereby providing more opportunities for a person to pass HIV infection from an extramarital partner to his or her spouse. These findings about high-risk behaviors can be used to better target future HIV-transmission-prevention efforts.

Evolutionary history of partible paternity in lowland South America

Partible paternity, the conception belief that more than one man can contribute to the formation of a fetus, is common in lowland South America and characterized by nonexclusive mating relationships and various institutionalized forms of recognition and investment by multiple cofathers. Previous work has emphasized the fitness benefits for women where partible paternity beliefs facilitate paternal investment from multiple men and may reduce the risk of infanticide. In this comparative study of 128 lowland South American societies, the prevalence of partible paternity beliefs may be as much as two times as common as biologically correct beliefs in singular paternity. Partible paternity beliefs are nearly ubiquitous in four large language families--Carib, Pano, Tupi, and Macro-Je. Phylogenetic reconstruction suggests that partible paternity evolved deep in Amazonian prehistory at the root of a tentative Je-Carib-Tupi clade. Partible paternity often occurs with uxorilocal postmarital residence (males transfer), although there are exceptions. Partible paternity may have benefits for both sexes, especially in societies where essentially all offspring are said to have multiple fathers. Despite a decrease in paternity certainty, at least some men probably benefit (or mitigate costs) by increasing their number of extramarital partners, using sexual access to their wives to formalize male alliances, and/or sharing paternity with close kin.

Pair-Bonded Humans Conform to Sexual Stereotypes in Web-Based Advertisements for Extra-Marital Partners

Partners advertisements provide advertisers with access to a large pool of prospective mates, and have proven useful in documenting sex differences in human mating preferences. We coded data from an Internet site (AshleyMadison.com) catering to advertisers engaged in existing pair-bonded relationships. While we predicted that pair-bonding may liberate advertisers from conforming to sexual stereotypes of male promiscuity and female choosiness, our results are uniformly consistent with those stereotypes. Our findings thus provide further evidence that human mating behavior is highly constrained by fundamental biological differences between males and females.

Sudden cardiac death of a woman during extramarital sex: A case report and review of the literature

Sudden death of cardiac patients related to sexual activity has been widely reported in the medical and forensic literature, specifically of male partners in heterosexual relationships, usually with extramarital partners. We present a unique case of a 46 year old woman who died during a sexual encounter with her lover. Cause of death was an acute cardiac failure due to hypertensive chronic cardiovascular disease, following sexual activity. The factors which contributed to her death are discussed and reviewed in light of similar reports in men.

Extra-marital sexual partnerships and male friendships in rural Malawi

Extra-marital sexual partnerships (EMSPs) are a major route of HIV/AIDS transmission in sub-Saharan Africa. In this paper, we investigate the roles of two types of male friendships - best friends and friends with whom they talk about AIDS - in determining whether men have EMSPs. Using data from men in rural Malawi, we find that men's current extra-marital sexual behavior is most closely correlated with their best friends', but that the behaviors of both types of friends are associated with men's subsequent EMSPs. These findings suggest that men's friendships could be used to help combat the AIDS epidemic.

Prevalence and risk factors for Chlamydia trachomatis infection among cross-border truck drivers in Hong Kong

Objectives:To determine the prevalence and risk factors for chlamydial infection in cross-border truck drivers.Methods:225 Hong Kong-based cross-border truck drivers were screened for chlamydial infection. Associations between infection and potential risk...