HIV Risk Driven By Number of Partners, Rather Than Concurrency

Health-e (Cape Town)

Kerry Cullinan

15 July 2011

A person’s risk of HIV is driven more by how many sexual partners they have in their lifetime than whether they have more than one lover at a time.

This is according to extensive research conducted over five years by scientists from the Africa Centre in Umkhanyakude district in rural KwaZulu-Natal. The results were published today (Friday 15 July) in the prestigious Lancet journal.

Debate has raged for years about the role that concurrent sexual partnerships play in HIV transmission, with a number of experts arguing that multiple concurrent partnerships is a key driver of the epidemic in Africa.

But according to Dr Frank Tanser, the study’s principal investigator: “Our results clearly demonstrate the impact of multiple partnering on the transmission of HIV but we find no evidence to suggest that sexual partnerships that overlap (concurrent) are playing a disproportionately large role in driving the high rate of new infections.”

Tanser and his team followed 7000 women who were all HIV negative to begin with over five years. Almost 10 percent (693 women) became infected with HIV during the study.

The researchers used questionnaires on sexual behaviour from almost 3000 men to inform their study. Close to three in 10 of these men reported having concurrent sexual relationships.

Using innovative geographical mapping, the researchers plotted communities where men reported a high level of concurrent partners as well as these where men reported higher numbers of lifetime sexual partners.

“The high rates of HIV infection were no different between communities with the highest levels of male concurrency and communities with low levels of concurrent partnerships,” said Tanser.

In contrast, women living in areas where local men reported an increase in the average number of reported life-time partners had a significantly higher risk of becoming infected with HIV infection.

However, the scientists noted that concurrent partners may have played an important role in the rapid spread of HIV during the early phase of the HIV epidemic.

According to the Africa Centre, which is part of the University of KwaZulu-Natal, the results show that HIV prevention messages need to be clear and directed at reducing the number of sexual partners “irrespective of whether these partnerships overlap”.

AllAfrica – All the Time