Multiple concurrent partnerships in zimbabwe

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. This led to reduction of high risk behaviours such as multiple concurrent partners. 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. A novel tool to assess community norms and attitudes to. Paper by lois chingandu executive director of safaids. Concurrent sexual partnerships help to explain africas high.

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. 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 determinants of multiple sexual partnerships among men in. Multiple concurrent partnerships among men and women aged. 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. Although concurrent sexual partnerships may play an important role in. Addressing multiple and concurrent sexual partnerships in generalized hiv epidemics. Multiple concurrent partnerships among men and women aged 15. Zimbabwe has one of the highest hiv prevalences in subsaharan africa at 12. Concurrent sexual partnerships among married zimbabweans ncbi. The prevalence of concurrent sexual partnerships among students in institutions of higher education in zimbabwe.

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 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. 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. Why hiv prevention needs anthropology leclercmadlala, s.

Multiple concurrent partnerships among men and women. The latter pattern of multiple sexual partnerships. Multiple and concurrent sexual partnerships in southern africa. 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. Among those eligible, 3,291 66% males and 4,052 72% females participated in the survey. A rise in aidsrelated deaths may have prompted many. The study segmented this group in terms of region, sex and income. Some researchers question the sterngth of this link. By then please realise that by engaging in multiple concurrent partnerships, you are not being cool but very stupid. 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%. Multiple concurrent partnerships among men and women aged 1534 in botswana baseline study, december 2007 diana gourvenec, noah taruberekera, obakeng mochaka, toby kasper. 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. A networklevel explanation for the differences in hiv prevalence in south africas racial groups. The sadc parliamentary forum wishes to engage a consultant under the following terms of reference.

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. 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. 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. Another process, a sadc regional consultation on social change communication for hiv prevention was held in swaziland in october 2006. 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. Married couples are at an increased risk of contracting hiv from sexual networks produced by. 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 purpose of these early papers was to explore and. 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. The determinants of multiple sexual partnerships among men. Partner reduction and fidelity appear to be the main behavioral changes accountable for the decrease in kenyas hiv infection rates. Given the significant role of multiple sexual partners in sustaining the hiv epidemic, reducing sexual hiv transmission is an international hiv prevention priority. A study carried out in zimbabwe by shumba et al 2011 concurred with.

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 are distinguished from multiple partnerships, which may be either sequential serial monogamy or concurrent overlapping. 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. Multiple and concurrent partnerships increase risk of hiv. Concurrent sexual partnerships and associated factors. Concurrent sexual partnerships and the spread of hiv the. 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. The term multiple and concurrent partners mcp actually incorporates two types of behavior. These concurrent partnerships enable hiv to spread quickly within sexual networks. Among currently married participants, 11% of men and 25% of women reported being in a polygynous union. Zimbabwe, and western kenya range from 20 to 40%, roughly an order of magnitude higher than anywhere else in the world. 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.

Despite a high level of awareness about ways of preventing hiv. Zimbabwe has successfully managed to reduce the estimated prevalence of hiv among adults aged 1549 years from 29. Research suggests that engaging in multiple concurrent partnerships mcp may be riskier than engaging in a series of sexual partnerships. The determinants of multiple sexual partnerships among men 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.

Descriptive and injunctive norms related to concurrent. In zimbabwe, the hiv prevalence rate has been on a steady decline to 15% where it is currently zimbabwe. 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 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. This study used a novel tool to collect data on community norms relating to the acceptability of concurrency in rural zimbabwe.

These concurrent partnerships enable hiv and other sexually transmitted infections to spread quickly within large sexual networks. 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. 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. 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. However, comparison of hiv prevalence with the traditional sexual behaviour indicators, such as age of. This study on multiple concurrent partnerships in zimbabwe was made possible through support from usaid and dfid. Multiple and concurrent partnerships mcps occur when a person is involved in more than one sexual partnership at the same time. 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. 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. 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. 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.

A sadc expert think tank meeting held in maseru, lesotho identified the major key drivers of hiv and aids. Full text concurrent sexual partnerships among married. The opinions expressed herein are those of the authors and do not necessarily reflect the views of the donors. Concurrent heterosexual partnerships, condom use, and hiv. Concurrent sexual partnerships play a key role in sustaining the hiv. Concurrency and other sexual partnership patterns reported in. Concurrent sexual partnerships among married zimbabweans. Concurrent sexual partnerships help to explain africas. The story of zimbabwe are small houses a key driver.

Concurrent sexual partnerships are hypothesized to be a contributing factor to malawis hiv epidemic. 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. Transactional and age disparate sex in hyperendemic. Namibia, south africa, swaziland, tanzania, zambia, and zimbabwe. To this end, one of the key hiv prevention strategies in zimbabwe is addressing multiple concurrent sexual partnerships, particularly among. Multiple concurrent partnerships mcp southern africa is the region in the world worstaffected by hivaids. Six questions exploring general concurrency concepts and 28 scenarios in which multiple partnerships might occur were developed and translated into shona. The risks of multiple partnerships versus concurrent partnerships are different. Concurrent sexual partnerships and the spread of hiv.

This pattern differs from that of the serial monogamy more common in the west, or the oneoff casual and commercial sexual encounters. Multiple and concurrent sexual partnerships in swaziland. 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. Individuals who have multiple sexual partners increase their risk of contracting hiv as each new relationship. A few qualitative studies have examined multiple partnerships either non concurrent or concurrent in rural malawi. The prevalence of concurrent sexual partnerships among students.

The practice by men and women of having more than one sexual partner at the same time, otherwise known as multiple concurrent sexual partners mcp, is a disturbing factor in our societies. Multiple and concurrent partnerships mcps increase risk of. Concurrent partnerships, acute infection and hiv epidemic. 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. Concurrent partnerships are powerful transmitters of hiv in the community. Do agedisparate relationships drive hiv incidence in. 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. Concurrent sexual partnerships play a key role in sustaining the hiv epidemic in zimbabwe. Although studies report multiple concurrent relationships to be prevalent, the actual. 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. Women and hiv in subsaharan africa aids research and.

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. Mcp or multiple concurrent partners can be described as when an individual has more than one sexual. Multiple and concurrent sexual partnerships among youth and adults in swaziland people in concurrent partnerships. Students in institutions of higher education in zimbabwe. Multiple sex partner and concurrent sex partner welfare jambo. Cultural scripts for multiple and concurrent partnerships in southern africa. Multiple sex partner and concurrent sex partner welfare.

Concurrent sexual partnerships play a key role in sustaining. Concurrent sexual partnerships, with two or more partners, are common practices in africa. A sexual network is a group of people who are connected to one another through direct or indirect sexual contact. Sociodemographic drivers of multiple sexual partnerships. As zimbabweans we are on board and so should you be. Determinants and monitoring indicators harare, zimbabwe. 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.

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. Multiple and concurrent partnerships mcps increase risk. In this commentary, individual, social, economic, and cultural factors underlying multiple concurrent partnerships are discussed. 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. 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. Descriptive and injunctive norms related to concurrent sexual. 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.

Intergenerational sex associated with stis, multiple and concurrent partnerships and introduction of hiv into younger cohort yes. Proponents of this dating link the hiv epidemic with the emergence of colonialism and growth of large colonial african cities, leading to social changes, including different patterns of sexual contact especially multiple, concurrent partnerships, the spread of prostitution, and the concomitant high frequency of genital ulcer diseases such as. The small house an ethnographic investigation into. Similar or larger reductions in multiple partnerships among adults have been reported in other national surveys.

Among those with a sexual partner in the past year, the proportion reporting at least one concurrent partnership was 17% in males and 0. In tanzania, however, the youth respondents included 30 year olds. Partner reduction and fidelity appear to be the main behavioral changes accountable for the decrease in. Multiple sexual partnerships, formerly married men, zimbabwe introduction over the years, considerable effort has been. Concurrent sexual partnerships help to explain africas high hiv prevalence. 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. A recruitment profile identified people involved in mcp. The hiv epidemic in zimbabwe is generalised and is largely driven by unprotected heterosexual sex.

Multiple and concurrent sexual partnerships in generalized. 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. However, in concurrent partnerships the partners behavior or participation in. The practice of mcps is found in both sexes, but more prevalent among men. Concurrent sexual partnership an overview sciencedirect. Abstract concurrent sexual partnerships are important in understanding the evolution and maintenance of the hiv heterosexual epidemic in subsaharan africa. 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. 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. Similar or larger reductions in multiple partnerships among adults have.