title: Population sexual behavior and HIV prevalence in Sub-Saharan Africa: missing links?
abstract: OBJECTIVE
  Patterns of sexual partnering should shape HIV transmission in human populations. The objective of this study was to assess empirical associations between population casual sex behavior and HIV prevalence, and between different measures of casual sex behavior.
  
  
  METHODS
  An ecological study design was applied to nationally representative data, those of the Demographic and Health Surveys, in 25 countries of Sub-Saharan Africa. Spearman rank correlation was used to assess different correlations for males and females and their statistical significance.
  
  
  RESULTS
  Correlations between HIV prevalence and means and variances of the number of casual sex partners were positive, but small and statistically insignificant. The majority of correlations across means and variances of the number of casual sex partners were positive, large, and statistically significant. However, all correlations between the means, as well as variances, and the variance of unmarried females were weak and statistically insignificant.
  
  
  CONCLUSIONS
  Population sexual behavior was not predictive of HIV prevalence across these countries. Nevertheless, the strong correlations across means and variances of sexual behavior suggest that self-reported sexual data are self-consistent and convey valid information content. Unmarried female behavior seemed puzzling, but could be playing an influential role in HIV transmission patterns.
authors.affiliation: Division of Bioinformatics, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Hokkaido, 001-0020, Japan; Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, New York, USA; JST, PRESTO, Kawaguchi, Saitama, Japan. Electronic address: omori@czc.hokudai.ac.jp.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Omori
authors.affiliation: Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, New York, USA; College of Public Health, Hamad bin Khalifa University, Doha, Qatar.
authors.forename: Laith J
authors.initials: LJ
authors.lastname: Abu-Raddad
mesh_terms: D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008393:Marriage; D008875:Middle Aged; D015995:Prevalence; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012747:Sexual Partners; D055815:Young Adult
keywords: Casual sex; Ecological analysis; HIV; Sexual behavior; Sub-Saharan Africa