Concurrent partnerships and HIV: an inconvenient truth

Epstein, Helen; Morris, Martina
January 2011
Journal of the International AIDS Society;2011, Vol. 14 Issue 1, p1
Academic Journal
The strength of the evidence linking concurrency to HIV epidemic severity in southern and eastern Africa led the Joint United Nations Programme on HIV/AIDS 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 AIDS epidemic in southern Africa. In a recent article in the Journal of the International AIDS Society, Larry Sawers and Eileen Stillwaggon attempt to challenge the evidence for the importance of concurrency and call for an end to research on the topic. However, their "systematic review of the evidence" is not an accurate summary of the research on concurrent partnerships and HIV, and it contains factual errors concerning the measurement and mathematical modelling of concurrency. Practical prevention-oriented research on concurrency is only just beginning. Most interventions to raise awareness about the risks of concurrency are less than two years old; few evaluations and no randomized-controlled trials of these programmes have been conducted. Determining whether these interventions can help people better assess their own risks and take steps to reduce them remains an important task for research. This kind of research is indeed the only way to obtain conclusive evidence on the role of concurrency, the programmes needed for effective prevention, the willingness of people to change behaviour, and the obstacles to change.


Related Articles

  • Attempting to explain heterogeneous HIV epidemics in sub-Saharan Africa: potential role of historical changes in risk behaviour and male circumcision. Orroth, Kate K.; White, Richard G.; Freeman, Esther E.; Bakker, Roel; Buvé, Anne; Glynn, Judith R.; Habbema, J. Dik F.; Hayes, Richard J.; Buvé, Anne // Sexually Transmitted Infections;Dec2011, Vol. 87 Issue 7, p640 

    Background: A key conclusion of the Four Cities Study, carried out to explore reasons for heterogeneity in the HIV epidemic between two cities in sub-Saharan Africa with relatively low prevalence (Cotonou and Yaoundé) and two with high prevalence (Kisumu and Ndola), was that...

  • Male Circumcision and HIV Transmission; What Do We Know? Jayathunge, Parana H. M.; McBride, William J. H.; MacLaren, David; Kaldor, John; Vallely, Andrew; Turville, Stuart // Open AIDS Journal;2014, Vol. 8, p31 

    Male circumcision (MC) has been shown to be protective against heterosexual HIV transmission and is being explored in some parts of the world as a means of combating the epidemic. The World Health Organization (WHO) recommends that MC be considered as an important component of HIV prevention in...

  • Impact of Male Circumcision on the HIV Epidemic in Papua New Guinea: A Country with Extensive Foreskin Cutting Practices. Gray, Richard T.; Vallely, Andrew; Wilson, David P.; Kaldor, John; MacLaren, David; Kelly-Hanku, Angela; Siba, Peter; Murray, John M. // PLoS ONE;Aug2014, Vol. 9 Issue 8, p1 

    The degree to which adult medical male circumcision (MC) programs can reduce new HIV infections in a moderate HIV prevalence country like Papua New Guinea (PNG) are uncertain especially given the widespread prevalence of longitudinal foreskin cuts among adult males. We estimated the likely...

  • Male Circumcision and the Epidemic Emergence of HIV-2 in West Africa. Sousa, João Dinis; Temudo, Marina Padrão; Hewlett, Barry Stephen; Camacho, Ricardo Jorge; Müller, Viktor; Vandamme, Anne-Mieke // PLoS ONE;12/7/2016, Vol. 11 Issue 12, p1 

    Background: Epidemic HIV-2 (groups A and B) emerged in humans circa 1930–40. Its closest ancestors are SIVsmm infecting sooty mangabeys from southwestern Côte d'Ivoire. The earliest large-scale serological surveys of HIV-2 in West Africa (1985–91) show a patchy spread. Côte...

  • Evaluating HIV prevention strategies for populations in key affected groups: the example of Cabo Verde. Monteiro, João; Galea, Sandro; Flanigan, Timothy; Monteiro, Maria; Friedman, Samuel; Marshall, Brandon // International Journal of Public Health;May2015, Vol. 60 Issue 4, p457 

    Objectives: We used an individual-based model to evaluate the effects of hypothetical prevention interventions on HIV incidence trajectories in a concentrated, mixed epidemic setting from 2011 to 2021, and using Cabo Verde as an example. Methods: Simulations were conducted to evaluate the extent...

  • AIDS in rural Africa: a paradigm for HIV-1 prevention. Hudson, Christopher P.; Hudson, C P // International Journal of STD & AIDS;Jul1996, Vol. 7 Issue 4, p236 

    Networks of concurrent sexual partnerships may be the primary cause of epidemic spread of HIV-1 in parts of sub-Saharan Africa. This pattern of sexual behaviour increases the likelihood that individuals experiencing primary HIV-1 infection transmit the virus to other persons. Networks of...

  • HIV/AIDS in Ethiopia: An Overview. Helmut Kloos; Damen Haile Mariam // Northeast African Studies;2000, Vol. 7 Issue 1, p13 

    Problem Statement: The rapidly growing literature on HIV/AIDS in Ethiopia has failed to examine the epidemic, its impacts, and the national prevention and control program in their socioeconomic, cultural, and political contexts. Objectives: This paper reviews the epidemiology, driving forces,...

  • Holy condom controversy.  // HIV Australia;2007, Vol. 7 Issue 1, p4 

    The article focuses on the support of the Archbishop of Sydney for the Pope's rejection of condom use to solve the global Acquired Immunodeficiency Syndrome (AIDS) epidemic. He reportedly states that condoms encourage irresponsibility and claims that Human Immunodeficiency Virus (HIV) infection...

  • WHO recommends circumcision to combat HIV infections in men in Africa. Moszynski, Peter // BMJ: British Medical Journal (International Edition);4/7/2007, Vol. 334 Issue 7596, p712 

    The article states that the World Health Organization and UNAIDS, the joint United Nations program on HIV and AIDS, is recommending male circumcision as a preventive measure against HIV infections. The World Health Organization and UNAIDS discussed this recommendation at an international...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics