Multiple concurrent partnerships in zimbabwe

Concurrent sexual partnerships are hypothesized to be a contributing factor to malawis hiv epidemic. The risks of multiple partnerships versus concurrent partnerships are different. Multiple concurrent partnerships among men and women aged. Research suggests that engaging in multiple concurrent partnerships mcp may be riskier than engaging in a series of sexual partnerships. A sexual network is a group of people who are connected to one another through direct or indirect sexual contact. Multiple and concurrent sexual partnerships among youth and adults in swaziland people in concurrent partnerships.

A sadc expert think tank meeting held in maseru, lesotho identified the major key drivers of hiv and aids. The determinants of multiple sexual partnerships among men in. In zimbabwe, the hiv prevalence rate has been on a steady decline to 15% where it is currently zimbabwe. Students in institutions of higher education in zimbabwe. Zimbabwe has successfully managed to reduce the estimated prevalence of hiv among adults aged 1549 years from 29. Determinants and monitoring indicators harare, zimbabwe. Some researchers question the sterngth of this link. These concurrent partnerships enable hiv to spread quickly within sexual networks. Multiple sex partner and concurrent sex partner welfare. Zimbabwe has one of the highest hiv prevalences in subsaharan africa at 12. Concurrent heterosexual partnerships, condom use, and hiv risk among the general population, zimbabwe psi helps support healthier lives psi makes it easier for people in the developing world to.

This pattern differs from that of the serial monogamy more common in the west, or the oneoff casual and commercial sexual encounters. Do agedisparate relationships drive hiv incidence in. In this commentary, individual, social, economic, and cultural factors underlying multiple concurrent partnerships are discussed. Concurrency and other sexual partnership patterns reported in. Descriptive and injunctive norms related to concurrent sexual. The practice of mcps is found in both sexes, but more prevalent among men.

These concurrent partnerships enable hiv and other sexually transmitted infections to spread quickly within large sexual networks. However, in concurrent partnerships the partner s behavior or participation in concurrent sexual relationships has a profound effect on their role as a transmitter of hiv. Multiple sexual partnerships, formerly married men, zimbabwe introduction over the years, considerable effort has been. Process evaluation of the multiple concurrent partnerships o icheke, break the chain campaign for hiv prevention in botswana from 2009 2012 botswana has the second highest hiv prevalence rate in southern africa, estimated at 17. Partner reduction and fidelity appear to be the main behavioral changes accountable for the decrease in kenyas hiv infection rates. Concurrent partnerships are distinguished from multiple partnerships, which may be either sequential serial monogamy or concurrent overlapping. The determinants of multiple sexual partnerships among men.

Descriptive and injunctive norms related to concurrent. Transactional and age disparate sex in hyperendemic. The small house an ethnographic investigation into. A study carried out in zimbabwe by shumba et al 2011 concurred with. As social norms influence health behavior and have been found to influence sexual behavior, the purpose of this study was to explore two types of norms, descriptive and injunctive norms, toward concurrent sexual partnerships in malawi. Paper by lois chingandu executive director of safaids introduction twentyfive years on, zimbabwe s hiv and aids epidemic is characterised by a prevalence rate of 18. Multiple and concurrent sexual partnerships in southern africa executive summary southern africa remains the epicentre of the global hiv and aids epidemic, with an hivprevalence rate of approximately 11%. By then please realise that by engaging in multiple concurrent partnerships, you are not being cool but very stupid. As zimbabweans we are on board and so should you be. Concurrent sexual partnership an overview sciencedirect. This study, by determining socioeconomic correlates of multiple sexual partnerships among formerly married men in zimbabwe, will contribute to the ongoing debate about understanding factors that are. Multiple concurrent partnerships among men and women. A rise in aidsrelated deaths may have prompted many zimbabweans to change their ways and reduce multiple concurrent partnerships posted by african press international on february 16, 2011 zimbabwe. Why hiv prevention needs anthropology leclercmadlala, s.

Concurrent sexual partnerships play a key role in sustaining. Cultural scripts for multiple and concurrent partnerships in southern africa. Multiple and concurrent sexual partnerships in swaziland. Among currently married participants, 11% of men and 25% of women reported being in a polygynous union. However, the desire for multiple sexual partners has convinced men that small houses could be a safer way of continuing to enjoy sex with multiple partners, rather than choosing monogamy and faithfulness, which are widely viewed as western ideals not applicable to africans. A novel tool to assess community norms and attitudes to. Multiple sexual partnershipsparticularly overlapping or concurrent partnershipsby both men and women lie at the root of the generalised epidemic of hiv in southern and eastern africa. This report provides an overview of 10 qualitative studies conducted by soul city regional programme partner organizations in botswana, lesotho, malawi, mozambique, namibia, south africa, swaziland, tanzania, zambia, and zimbabwe. Zimbabwe from 1998 through 201 1 to evaluate the relative populationlevel changes in different types of sex partnerships multiple sexual partnerships as a whole, concurrency, and polygyny during this period of declining hiv prevalence. If polygyny is a more stable and institutionalized form of concur. Multiple concurrent partnerships mcp southern africa is the region in the world worstaffected by hivaids. Small houses are a form of concurrent relationship in which a person is having regular sexual relations with another person, while at the same time continuing to have sex with their current primary sexual partner. Aug 17, 2011 although concurrent sexual partnerships may play an important role in hiv transmission in africa, the lack of an agreed definition of concurrency and of standard methodological approaches has hindered studies.

Among those with a sexual partner in the past year, the proportion reporting at least one concurrent partnership was 17% in males and 0. Mar 15, 2011 between 1995 and 2000, morris and kretzschmar published a series of studies showing that, all other things equal, hiv would spread much more rapidly through a population in which multiple partnerships were concurrent than through one in which all multiple partnerships were serial 7174. Consequently, public health campaigns educate people about the dangers of small housing as part of multiple concurrent partnerships and sexual networks discourses linked to the hiv epidemic. This study on multiple concurrent partnerships in zimbabwe was made possible through support from usaid and dfid. Partner reduction and fidelity appear to be the main behavioral changes accountable for the decrease in. Full text concurrent sexual partnerships among married. Given the significant role of multiple sexual partners in sustaining the hiv epidemic, reducing sexual hiv transmission is an international hiv prevention priority. An number of studies have shown that the practice of men and women having multiple or concurrent sexual partners is a key driver in the hiv epidemic and plays a particular role in the high burden of infection in southern africa. Paper by lois chingandu executive director of safaids. However, in concurrent partnerships the partners behavior or participation in concurrent sexual relationships has a profound effect on their role as a transmitter of hiv. Oct 18, 2010 as the debate heats up about whether or not multiple concurrent partnerships mcps are major drivers of africas hiv epidemics, irinplusnews takes a look at the evolution of the theory behind mcps. The theory that multiple, overlapping sexual partnerships are a key driver of generalised hiv epidemics in africa has been attacked as being based on insubstantial evidence. A sexual partnership is considered to be concurrent if a person reports having two or more sexual partners in a month epstein and morris, 2011, soul city, 2007. The determinants of multiple sexual partnerships among men in zimbabwe.

Dec 22, 2009 the theory that multiple, overlapping sexual partnerships are a key driver of generalised hiv epidemics in africa has been attacked as being based on insubstantial evidence. Concurrent partnerships, acute infection and hiv epidemic. Concurrent sexual partnerships and associated factors. The prevalence of concurrent sexual partnerships among students in institutions of higher education in zimbabwe. Understanding the causes of sexual concurrency in a given geography and with a given group is an important step toward developing effective hiv prevention programming. Among those eligible, 3,291 66% males and 4,052 72% females participated in the survey. Concurrent sexual partnerships and the spread of hiv the. The story of zimbabwe are small houses a key driver. Paper by lois chingandu executive director of safaids introduction twentyfive years on, zimbabwes hiv and aids epidemic is characterised by a prevalence rate of 18. A recruitment profile identified people involved in mcp. The opinions expressed herein are those of the authors and do not necessarily reflect the views of the donors. Concurrent sexual partnerships among married zimbabweans implications for hiv prevention esther mugweni,1 stephen pearson,2 mayeh omar2 1ucl department of infection and population health, university college london, london, 2the nuffield centre for international health and development, university of leeds, leeds, uk background. Concurrent sexual partnerships help to explain africas.

Concurrent sexual partnerships among married zimbabweans ncbi. The latter pattern of multiple sexual partnerships. Mcp or multiple concurrent partners can be described as when an individual has more than one sexual. Far fewer young women reported multiple and concurrent partnerships, but we cannot definitively conclude that concurrency was uncommon for women, because stigma towards womens multiple sexual partnerships might contribute to substantial underreporting, as was found in extensive qualitative research in the study population. The hiv epidemic in zimbabwe is generalised and is largely driven by unprotected heterosexual sex. Multiple and concurrent partnerships mcps increase risk of. As the debate heats up about whether or not multiple concurrent partnerships mcps are major drivers of africas hiv epidemics, irinplusnews takes a look at the evolution of the theory behind mcps. Concurrent sexual partnerships and the spread of hiv. Multiple sex partner and concurrent sex partner welfare jambo. Concurrent sexual partnerships help to explain africas high hiv prevalence. While it is possible to measure individual attitudes around sensitive behaviours through questionnaire surveys, studies suggest that responses may be subject to social desirability bias and may not reflect community norms.

Similar or larger reductions in multiple partnerships among adults have been reported in other national surveys. Concurrent sexual partnerships play a key role in sustaining the hiv epidemic in zimbabwe. The term multiple concurrent sexual partnerships is used to define a situation where partnerships overlap in time, either where two or more partnerships continue over the same time period, or where one partnership. Hivaids, sexual networks, concurrent partnerships, acute infection, zimbabwe, mathematical modeling, stochastic simulation, ergm introduction hiv infection is defined by three general stages of diseaseacute infection, chronic infection, and aidscoinciding with variation in viral load, cd4 cell count, and clinical manifestations. Multiple concurrent partnerships mcp is defined as overlapping sexual relationships where sexual intercourse with one partner occurs between two acts of sexual intercourse with another partner unaids 2009. The study segmented this group in terms of region, sex and income.

Sociodemographic drivers of multiple sexual partnerships. Concurrent heterosexual partnerships, condom use, and hiv risk among the general population, zimbabwe psi helps support healthier lives psi makes it easier for people in the developing world to lead healthier lives and plan the families they desire. Women and hiv in subsaharan africa aids research and. Multiple concurrent partnerships among men and women aged 15. For the individual with multiple partners but not concurrent partners, their risk of acquiring hiv is directly related to the number of sexual partners they have over time.

Of increasing interest to epidemiologists is the observation that in africa men and women often have more than onetypically two or perhaps threeconcurrent partnerships that can overlap for months or years. Multiple and concurrent sexual partnerships among youth and adults in swaziland mobility, wealth inequalities, cultural factors and gender inequality, explain the high hiv prevalence in the region. Multiple and concurrent partnerships mcps increase risk. Multiple and concurrent sexual partnerships in southern africa. This study used a novel tool to collect data on community norms relating to the acceptability of concurrency in rural zimbabwe. In 2006, a joint united nations programme on hivaids unaids and southern african development community sadc group of experts concluded that high rates of concurrent or overlapping sexual partnerships, combined with low rates of male circumcision and infrequent condom use, are major drivers of the aids epidemic in southern africa. Namibia, south africa, swaziland, tanzania, zambia, and zimbabwe. Although studies report multiple concurrent relationships to be prevalent, the actual. In a longstanding general population cohort in rural uganda we assessed the prevalence of concurrency and investigated its association with sociodemographic and behavioural factors and. Similar or larger reductions in multiple partnerships among adults have.

Multiple and concurrent partnerships increase risk of hiv. The prevalence of concurrent sexual partnerships among students. Concurrent sexual partnerships play a key role in sustaining the hiv. In order to identify and define psychosocial determinants of concurrent partnerships in zimbabwe, we first needed to obtain data on types of male and female sexual relationships, the patterns and contexts of mcp, and use of condoms with concurrent partners. However, comparison of hiv prevalence with the traditional sexual behaviour indicators, such as age of. Concurrent sexual partnerships, with two or more partners, are common practices in africa. Although concurrent sexual partnerships may play an important role in. Multiple and concurrent sexual partnerships in generalized. The determinants of multiple sexual partnerships among men in zimbabwe a research report submitted to the faculty of health sciences, university of the witwatersrand, johannesburg, in partial fulfillment of degree of master of science in medicine in epidemiology and biostatistics by enard mutenheri student number 376637 the requirements for the.

Another process, a sadc regional consultation on social change communication for hiv prevention was held in swaziland in october 2006. The term multiple and concurrent partners mcp actually incorporates two types of behavior. However, in concurrent partnerships the partners behavior or participation in. A rise in aidsrelated deaths may have prompted many. Multiple and concurrent partnerships mcps occur when a person is involved in more than one sexual partnership at the same time. Zimbabwe, and western kenya range from 20 to 40%, roughly an order of magnitude higher than anywhere else in the world. Concurrent sexual partnerships help to explain africas high. Intergenerational sex associated with stis, multiple and concurrent partnerships and introduction of hiv into younger cohort yes. Abstract concurrent sexual partnerships are important in understanding the evolution and maintenance of the hiv heterosexual epidemic in subsaharan africa. Multiple sexual partnerships particularly overlapping or concurrent partnerships by both men and women lie at the root of the generalised epidemic of hiv in southern and eastern africa. A networklevel explanation for the differences in hiv prevalence in south africas racial groups. Despite a high level of awareness about ways of preventing hiv.

The contributions of reductions in numbers of sex partners to reductions in hiv incidence in zimbabwe and elsewhere 5, 6 are well documented, but there remains debate about the relative importance of reductions of different types of partnerships to controlling hiv epidemics, particularly multiple exclusive partnerships versus nonexclusive. Multiple concurrent partnerships among men and women aged 1534 in botswana baseline study, december 2007 diana gourvenec, noah taruberekera, obakeng mochaka, toby kasper. Concurrent sexual partnerships among married zimbabweans. Married couples are at an increased risk of contracting hiv from sexual networks produced by. To this end, one of the key hiv prevention strategies in zimbabwe is addressing multiple concurrent sexual partnerships, particularly among. The sadc parliamentary forum wishes to engage a consultant under the following terms of reference. Since presumably nearly all married people would have sex at least occasionally with their spouses and given that most adults in zimbabwe are married, this implies a sizeable reduction in the level of concurrent partnerships. The critics, writing in the journals aids and behavior and the lancet, argue that researchers lack a precise definition of concurrency or a standard way to measure it, and that the data do not show a significant. Addressing multiple and concurrent sexual partnerships in generalized hiv epidemics. Consultant sadc genderbased violence model law short term research inventory and compliance of existing genderbased violence laws of the sadc member states to international laws. Individuals who have multiple sexual partners increase their risk of contracting hiv as each new relationship. The purpose of the national multiple concurrent partnerships mcp campaign plan is to fulfil the commitment under the national operational plan for scaling up hiv prevention in botswana, 20082010 to a highprofile, national, multiyear behaviour change campaign specifically focussing on the acknowledged drivers of the epidemic. The purpose of these early papers was to explore and. The practice of multiple sexual partnerships has been shown to be the most important risk factor in the transmission of hiv, 19 but the characteristics of each sexual partnership e.