Determinants of concurrent sexual partnerships within stable. These concurrent partnerships enable hiv to spread quickly within sexual networks. Zvoushe hardlife university of zimbabwe department of political and administrative studies, p. Similar results were found in a study in zimbabwe by kesby. It is clear, however, that multiple sexual partners, whether serial or concurrent. Local perceptions of the forms, timing and causes of behavior change in response to the aids epidemic in zimbabwe. Full text concurrent sexual partnerships among married.
Partner reduction and fidelity appear to be the main behavioral changes accountable for the decrease in kenyas hiv infection rates. Concurrent sexual partnerships and the hiv epidemic in subsaharan africa. Dissatisfaction in relationships many participants talked about being sexually dissatisfied with their steady or love partners. Given the significant role of multiple sexual partners in sustaining the hiv epidemic, reducing sexual hiv transmission is an international hiv prevention priority. In 2000, king letsie iii declared hivaids a natural disaster. Concurrent partnerships, acute infection and hiv epidemic dynamics among young adults in zimbabwe. This kind of cultural briefs leaves the woman whose man is having multiple concurrent partners with self pity and self blame. Created by the iud subcommittee of usaids maximizing access and quality initiative. The o icheke multiple concurrent partnership campaign was positively viewed as playing a key role in addressing the apparent knowledge gap regarding the impacts of these partnerships and in changing peoples attitudes towards mcp and discouraging wide sexual networks. Launched on south african television in june 2008, the scrutinize campaign was a yearlong series of hiv prevention ads targeting multiple and concurrent sexual partnerships. Our experts trained a local organization in lesotho to help couples and communities discuss multiple concurrent sexual partnerships, which increase the risk of spreading hiv. Created through a collaborative effort by multiple organizations and projects. By using this site, you agree that we may store and access cookies on your device. Concurrent sexual partnerships among married zimbabweans.
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. In some parts of africa, where over twothirds of infections occur globally, hiv has expanded outside these highrisk groups, creating generalized, predominantly heterosexual. Concurrent sexual partnerships and associated factors. Pdf trends in concurrency, polygyny, and multiple sex. Multiple concurrent partnerships among men and women aged 15. Although concurrent sexual partnerships may play an important role in hiv. Jan 01, 2014 multiple episodes of unprotected vaginal intercourse with 2 of their most recent partners was reported by 60% of women who had both concurrent partnerships and nonmonogamous partners, 50% with only concurrent partners and no partners concurrency, and 33% with only partners concurrency versus 14% of women with neither type of concurrency. Concurrent sexual partnerships and the spread of hiv the. Ninety percent of new hiv infections in zambia are driven by structural and biomedical factors such as multiple and concurrent sexual partnerships, mother to child transmission, low and inconsistent condom use, low levels. Ldhs data from 2009 indicates that bonyatsi practices, the culturally sanctioned practice of maintaining many sexual partners, continues after marriage, as 9% of women and 24. Reducing multiple concurrent partnerships in mozambique. In lesotho, with low organized polygyny but high rates of migrant labor, over half of men and two in five women report more than one current regular partner. Tadiwa nyatangapfupa, communications officer for nac.
A youth hiv prevention campaign addressing multiple and. Bulled 2015 argues that the primary risk factor for heterosexual partnerships is multiple concurrent partnerships mcp. Namibia, south africa, swaziland, tanzania, zambia, and zimbabwe. Multiple and concurrent sexual partnerships among youth and adults in swaziland people in concurrent partnerships.
Sadc and unaids concluded that high levels of multiple and concurrent sexual partnerships by men and women with insufficient consistent, correct condom use, combined with low levels of male circumcision are the key drivers of the epidemic in the subregion. The time has come for common ground on preventing sexual. A recruitment profile identified people involved in mcp. Nov 26, 2008 multiple concurrent partnerships provide a compelling, if partial, resolution of the apparent paradox of africas high hiv infection rates. Multiple and concurrent sexual partnerships among youth and adults in swaziland alcohol emerged as a major contributing factor to multiple sexual partners. Hivaids in lesotho constitutes a very serious threat to the basotho people and lesothos economic development.
The study segmented this group in terms of region, sex and income. Even if multiple concurrent partnerships turn out to represent a potentially greater risk for hiv infection during the acute stage, programmes that have as their goal the simple reduction in the number of mcp are losing sight of the real goal of hiv prevention. Dec 01, 2011 launched on south african television in june 2008, the scrutinize campaign was a yearlong series of hiv prevention ads targeting multiple and concurrent sexual partnerships. Why are multiple, concurrent sexual partnerships very bad and why does it spread hiv very fast. Tackling hivaids through social and behavior change.
Factors that contribute to mcps among young people may include lack of communication. Zimbabwe government and orc macro, 2007, where the mining industry is. Earlier simulation models show that the network effect of concurrency can increase hiv incidence, but those models do not account for the coital dilution effect nonprimary partnerships have lower coital frequency than primary partnerships. Oct 05, 2011 in the era of hiv and aids, the inequality of men and women is fueling the spreading of the epidemic as multiple concurrent partnerships are the order of the day with younger women going for older men even outside the institution of marriage as a means of survival, where these young women have lesser power to negotiate for safer sex. Goodreau s, cassels s, kasprzyk d, montano d, greek a, morris m. 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.
Addressing these partnerships is an international hiv prevention priority. Concurrency is different from having multiple partners over a long. Regarding sociodemographic factors associated with concurrency, females. Behavior change behind huge decline in hiv rates in zimbabwe. Multiple and concurrent sexual partnerships in southern africa reasons for multiple concurrent partnerships participants reported a range of reasons for their involvement in mcp. Hivaids centre for infectious disease research in zambia. 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. Multiple concurrent partnerships among men and women aged. In addition, zimbabwe has one of the highest rates of orphaning in the world.
Multiple and concurrent partnerships mcps occur when a person is involved in more than one sexual partnership at the same time. 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. Some hiv experts think the main reason for the decline in zimbabwe is the economic collapse, first author daniel halperin, phd, lecturer on global health at. Controlling and preventing hiv in southern africa inquiries. Contributions of proximate causes to the hiv decline in zimbabwe. Married couples are at an increased risk of contracting hiv from sexual networks produced by concurrent sexual partnerships. Concurrent sexual partnerships and primary hiv infection. Queen consulting group hiring sql report developer in. According to current estimates from the joint united nations programme on hivaids unaids, adult hiv prevalence is 12.
Associated risk factors of stis and multiple sexual. Zimbabwe is one of unaids priority countries for the scale up of voluntary medical male circumcision vmmc, and vmmc being listed in the countrys current prevention strategy zimbabwe. Irreverent and humorous, with strong, colorful visuals, the campaigns ads were markedly different from previous south african hiv prevention campaigns for youth. Ability to organize, plan, and carry out multiple concurrent objectives or activities, an effectively make judgments in prioritizing and time allocation ability to work independently as well as. Reducing multiple concurrent partnerships and implementing male circumcision on a large scale represent areas where future prevention efforts should focus. Mobile workers, such as truck drivers, were identified as the group most involved in. People often have sexual encounters because they are drunk and their judgement is impaired. Concurrent sexual partnerships play a key role in sustaining the hiv epidemic in zimbabwe. Mcp is the practice of having multiple longterm sexual partners that overlap in time, often for months or years. A sexual network is a group of people who are connected to one another through direct or indirect sexual contact.
Students in institutions of higher education in zimbabwe. Concurrent sexual partnerships among married zimbabweans ncbi. Fhi 360 uses sbcc to build partnerships between women and men and transform attitudes and beliefs about gender that fuel the epidemic. Each individual is linked to his or her own sexual partners, to their partners sexual partners, to those peoples sexual partners, and so on. Mcp, combined with reducing multiple concurrent partnerships. Psi collects cookies on this website to ensure you have the best experience. Our qualitative study presents the socioeconomic factors that contribute to. Therefore, the more men and women in a society have more than one partner, the more people in the network become linked to each other.
Hiv is a member of the genus lentivirus, part of the family retroviridae. S everal decades into the aids pandemic, hiv transmission in most of the world remains firmly concentrated among sex workers, men who have sex with men msm, injecting drug users idus, and their sex partners 11. Our analysis focused specifically on beliefs about how relationship factors influence. Lentiviruses have many morphologies and biological properties in common. Multiple and concurrent sexual partnerships in swaziland. 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. Partner reduction and fidelity appear to be the main behavioral changes accountable for the decrease in. Many species are infected by lentiviruses, which are characteristically responsible for longduration illnesses with a long incubation period. Sadc in may 2006 pointed to high of multiple and concurrent sexual partnerships by men and women, with insufficient consistent, correct condom use, and combined with low levels of male circumcision, as the key drivers of the hiv epidemic in the region.
Multiple and concurrent sexual partnerships in southern africa. There are various reasons why men and women participate in multiple concurrent. Students in zimbabwe are said to be sexually active from as early as. Multiple partnerships and nonmarital concurrency were reported much more frequently by men 34. Concurrent sexual partnerships play a key role in sustaining the hiv epidemic in. Recently a woman told me i was sharing with a woman church lay leader one that i respect like my own mother in a rural congregation, that my husband and i were having some misunderstanding. Even though there are many ways to refer to such partnerships, the risk is the same. Created by k4health and the global health knowledge collaborative. Concurrent partnerships are powerful transmitters of hiv in the community. Basically, large sexual networks where everyone has sex with everyone, eventually, and no consistent safe sex is had. 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. Indeed, aids has been identified as the leading cause of death ahead of.
Earlier simulation models show that the network effect of concurrency can increase hiv incidence, but those models do not account for the coital dilution effect nonprimary partnerships have lower coital frequency than. Concurrent sexual partnership an overview sciencedirect. The o icheke multiple concurrent partnership campaign was positively viewed as playing a key role in addressing the apparent knowledge gap regarding the impacts of these partnerships and in changing peoples attitudes towards mcp. The story of zimbabwe are small houses a key driver. The strength of the evidence linking concurrency to hiv epidemic severity in southern and eastern africa led the joint united nations programme on hivaids and the southern african development community in 2006 to conclude that high rates of concurrent sexual partnerships, combined with low rates of male circumcision and infrequent condom use, are major drivers of the. In a follow up study in zimbabwe, multiple sexual partnerships msp prevalence of 40% for males and 6% females was reported and a recent study of community norms and attitudes towards multiple and concurrent sexual partnership reported a prevalence of 37. The prevalence of concurrent sexual partnerships among students. Zimbabwe has successfully managed to reduce the estimated prevalence of hiv among adults aged 1549 years from 29. It is roughly spherical with a diameter of about 120 nm, around 60 times smaller than a red blood cell. Dec, 20 concurrent partnerships are powerful transmitters of hiv in the community. 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. 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. Zimbabwe is a landlocked sovereign state located in southern africa. What emerges clearly from the whogpa data is that multiple concurrent partnerships are frequent in africa.
What impact do multiple concurrent sexual partnerships. Close to 600,000 people infected with hiv and aids are in need of treatment right now and yet less than 10% are accessing the life prolonging drugs. I dont use a condom with my regular partner because i. Mozambique is one of several countries where psi is addressing the phenomenon of multiple concurrent partnerships mcp, known to be an important factor in the high hiv prevalence in eastern and southern africa. For example, it has been argued that the migrant labour system, imposed under colonial. Concurrent sexual partnerships and the spread of hiv. This study, by determining socioeconomic correlates of multiple sexual partnerships among formerly married men in zimbabwe, will contribute to the. The concurrency hypothesis asserts that high prevalence of overlapping sexual partnerships explains extraordinarily high hiv levels in subsaharan africa. For example, it has been argued that the migrant labour system, imposed under colonial and apartheid rule, transformed south africa into an. Multiple and concurrent partnerships mcps increase risk.
Mineral exports, gold, 1 agriculture, and tourism are the main foreign currency earners of zimbabwe. Multiple and concurrent partnerships, the big house, spare tire, and sugar daddythese are just a few of the terms used to refer to multiple sexual partners. Mc is a biomedical intervention that is safe, effective, and ready to be put to work in severely affected regions. Hiv is different in structure from other retroviruses. It is composed of two copies of positivesense singlestranded rna that codes for the viruss nine genes enclosed by a conical capsid composed of 2,000 copies of the viral protein p24. Women and hiv in subsaharan africa aids research and. According to the joint united nations programme on hivaids unaids in 2016, lesothos adult prevalence rate of 25% is the second. Multiple concurrent partnerships provide a compelling, if partial, resolution of the apparent paradox of africas high hiv infection rates.
Since its initial detection in 1986, hivaids has spread at alarming rates in lesotho. Multiple concurrent partnerships among men and women. Addressing multiple and concurrent sexual partnerships in generalized hiv. Concurrent sexual partnerships, with two or more partners, are common practices in africa.
In this commentary, individual, social, economic, and cultural factors underlying multiple concurrent partnerships are discussed. The hivaids pandemic is an urgent health and growing humanitarian crisis, especially in the highprevalence regions of subsaharan africa where most new infections continue to occur. Married couples are at an increased risk of contracting hiv from sexual networks produced by. Using demographic and health surveys, the analysis shows that migrant miners ages 3044 are 15 percentage points more likely to be hiv positive, and women whose partner is a migrant miner are 8. On world aids day dec 1, two decades after the discovery of the virus that causes aids and after many millions of deaths, we believe it is critical to reach consensus on a sound publichealth approach to the. Ministry of health and child welfare 2008 zimbabwe national hiv prevention strategy document. Multiple concurrent partnerships defining the problem.
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