title: A framework of sexual partnerships: risks and implications for HIV prevention in Africa.
abstract: The global diversity of HIV epidemics can be explained in part by types and patterns of sexual partnerships. We offer a typology of sexual partnerships that corresponds to varying levels of HIV-transmission risk to help guide thinking about appropriate behavioral interventions, particularly in the epidemics of sub-Saharan Africa. Declines in HIV prevalence have been associated with reductions in numbers of sex partners, whereas many other prevention strategies have not been demonstrated to reduce HIV transmission at a population level. We suggest a reorientation of current prevention efforts, based on the epidemiology of sexually transmitted HIV epidemics and trends in sexual behavior change. Concurrent sexual partnerships are likely to play a large role in transmission dynamics in the generalized epidemics of East and Southern Africa, and should be addressed through improved behavior-change interventions.
authors.affiliation: AIDS Prevention Research Project, Harvard Center for Population and Development Studies, USA.
authors.forename: Edward C
authors.initials: EC
authors.lastname: Green
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Mah
authors.forename: Allison
authors.initials: A
authors.lastname: Ruark
authors.forename: Norman
authors.initials: N
authors.lastname: Hearst
mesh_terms: D000349:Africa / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission*; D015438:Health Behavior; D006801:Humans; D007398:Interpersonal Relations; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior; D012747:Sexual Partners; D019562:Viral Load