title: Partner concurrency and HIV infection risk in South Africa.
abstract: BACKGROUND
  The relationship between concurrent sexual partnerships and HIV risk is not fully understood. Evidence on the relationship between partner concurrency (one's sexual partner has another partner) and individual HIV risk is limited. In this study, the relationship between reported sexual partner concurrency and the risk of HIV infection was explored among South Africans.
  
  
  METHODS
  Data from the third South African national HIV survey were used. In this survey, performed in 2008, questionnaires and HIV tests were administered to a nationally representative sample of 15031 persons. Bivariate analysis and multiple logistic regression were used to evaluate the relationship between partner concurrency and HIV serostatus. Spearman's correlation was used to test the association between the prevalence of HIV and partner concurrency by race in women.
  
  
  RESULTS
  The relationship between HIV prevalence and partner concurrency varied by race. At a cross-racial level there was a positive association between HIV prevalence and partner concurrency for women (rho=0.95, p=0.05). Among coloured, white, and Indian persons, HIV prevalence and partner concurrency rates were too low to allow further statistical testing. In the bivariate analysis, black African women who reported partner concurrency had a higher prevalence of HIV (36% (95% confidence interval (CI) 29.7-42.0) vs. 23% (95% CI 19.6-26.1), p<0.001). After controlling for demographic, social, biological, and behavioural variables, the association remained statistically significant (adjusted odds ratio (aOR) 1.4, p=0.04). The association was stronger among 15-29-year-old black African women (aOR 1.8, p=0.03) than among women aged 30 years and older (aOR 1.3, p=0.36).
  
  
  CONCLUSIONS
  These results suggest that partner concurrency may increase the HIV infection risk for black South African women, and in particular, for younger women.
authors.affiliation: HIV/STI Unit, Institute of Tropical Medicine, Nationalestraat 155, Antwerpen 2000, Belgium; Department of Medicine, University of Cape Town, South Africa. Electronic address: ckenyon@itg.be.
authors.forename: Chris R
authors.initials: CR
authors.lastname: Kenyon
authors.affiliation: HIV/STI Unit, Institute of Tropical Medicine, Nationalestraat 155, Antwerpen 2000, Belgium.
authors.forename: Achilleas
authors.initials: A
authors.lastname: Tsoumanis
authors.affiliation: Department of Medical Microbiology, Faculty of Health Sciences, College of Medicine, University of Manitoba, Winnipeg, Canada; Department of Epidemiology and Social Medicine, Faculty of Health Sciences, University of Antwerp, Belgium.
authors.forename: Ilan S
authors.initials: IS
authors.lastname: Schwartz
authors.affiliation: Southern Africa Labour and Development Research Unit, Department of Economics, University of Cape Town, Cape Town, South Africa.
authors.forename: Brendan
authors.initials: B
authors.lastname: Maughan-Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012747:Sexual Partners; D013019:South Africa / Q000453:epidemiology
keywords: Concurrent sexual partnerships; Gender; HIV/AIDS; Race; South Africa