Multiple sex partner and concurrent sex partner

Multiple & Concurrent Partnerships

Introduction

Definition of the Prevention Area

Multiple sex partner define as 

Having more than one partner at the same time or all at once or over a period of time 

Individuals who have multiple sexual partners increase their risk of contracting HIV as each new relationship introduces another pathway for New infection 

    Concurrent sex partner 

 defined as having two or more partnerships that overlap in time, also increase risk and have been recently identified as a likely driver of the spread of HIV.

Sexual practices vary widely, and individuals who have multiple sexual partners may or may not engage in concurrent sexual partnerships. Researchers distinguish serial monogamy, in which an individual may have multiple sexual partners without any overlapping partnerships, from concurrency. Individuals who are involved in concurrent relationships may or may not have a high number of lifetime sexual partners since some concurrent partnerships are long-term, stable, or "closed" relationships, such as polygamy. There is some controversy about the nature of various cultural norms and the risks entailed by these relationships.

At a time when HIV rates are declining in other parts of the world, HIV prevalence in East and Southern Africa remains high and is thought to be due to several factors: high rates of multiple and concurrent sexual partnerships (MCP), low rates of male circumcision, and inconsistent and/or incorrect condom use.

Epidemiological Justification for the Prevention Area

Since MCP clearly increase the risk of HIV transmission, partner reduction strategies have been undertaken in countries such as Uganda, Thailand, Kenya, and Zimbabwe. These programs have been followed by reductions in HIV incidence and/or prevalence. However, no large-scale population-based surveys have been able to directly link reductions in MCP with a decrease in HIV epidemics.

Although these types of partnerships are not mutually exclusive, different risks are associated with multiple versus concurrent sexual partnerships. The risks of multiple partnerships versus concurrent partnerships are different. For the individual with multiple partners (but not concurrent partners), their risk of acquiring HIV is directly related to the number of sexual partners they have over time. However, in concurrent partnerships the partner’s behavior or participation in concurrent sexual relationships has a profound effect on their role as a transmitter of HIV. Because of this, an individual’s risk cannot be calculated solely on the basis of his or her behavior, but can only be assessed in light of their partner’s behavior. For example, an individual may have only one sexual partner, but if that partner is connected to a wider sexual network through concurrent sexual relationships, then the individual is at higher risk of acquiring HIV.