Researchers question evidence linking overlapping sexual partners and African HIV rates

Oct 22, 2009

Contrary to conventional wisdom, scientific evidence proving that overlapping multiple sexual partners — concurrency — drives the HIV epidemic in sub-Saharan Africa is actually quite limited, Brown University researchers have concluded.

As a result, they say, far more research is needed to prove what has been a long-held assertion for close to 15 years — that the sexual practice of concurrency has accelerated the spread of HIV in Africa.

"People have just accepted at face value that this is the main thing that's driving the epidemic," said epidemiologist Mark Lurie, assistant professor and medicine. "But the evidence that concurrency is a major factor is very weak."

Lurie and co-author Samantha Rosenthal detail their argument in an upcoming issue of the journal and Behavior. The article is available online now. Rosenthal is a graduate student in public health at Brown.

Lurie and Rosenthal say there is no conclusive evidence that overlapping multiple sexual partners increases the size of an HIV epidemic, accelerates the speed at which the virus is transmitted or makes HIV more persistent in a given population. They drew their conclusion by looking at previous studies that examined concurrency in any way.

The reason, they say, is that HIV epidemics can't be explained by a single variable. A number of factors are more likely, with some factors more important in some geographic areas than others.

"The studies you need to prove causality don't exist," Lurie said. "None of those studies have been done."

The researchers don't dispute the notion that concurrent sexual relationships could "theoretically" play a major role driving HIV transmission through networks of people. But before this can be proven true, Lurie and Rosenthal say, a number of research initiatives are needed including:

  • improved methods for measuring both and the duration or overlapping of sexual partnerships;
  • a common definition of concurrency. Lurie and Rosenthal write that concurrency is defined many different ways in health literature, which complicates scientific measurement of its affects on HIV transmission. Some measurements, for example, only count ongoing sexual relationships and not casual partnerships;
  • longitudinal studies that measure both concurrency and incidence of HIV infection. This is needed, the researchers said, to accurately determine whether there is a link between concurrent sexual relationships and increased .
Without the added data, Lurie said, there is a risk that public policy-makers, development agencies, and aid organizations are spending too much money on campaigns against taking on overlapping multiple sexual partners when other causes may matter more.

"We are also worried about the unintended consequences of concurrency interventions," Lurie said. "If you are giving a message that says 'Don't have concurrent partnerships,' then people can easily take away from that the message to have lots of partnerships as long as they don't overlap."

The result, Lurie said, leads to a waste of resources and "considerable harm" to a population that could inadvertently end up spreading .

Source: Brown University (news : web)

Explore further: HIV+ women respond well to HPV vaccine

add to favorites email to friend print save as pdf

Related Stories

Migration played key role in HIV spread in South Africa

Feb 14, 2007

Using data collected from nearly 500 men and women living in bustling towns and rural villages, researchers from Brown University, Harvard Medical School and Imperial College London created a mathematical model that shows ...

Major shift in HIV prevention priorities needed

May 08, 2008

According to a new policy analysis led by researchers at the Harvard School of Public Health (HSPH) and the University of California, Berkeley, the most common HIV prevention strategies—condom promotion, HIV testing, treatment ...

Recommended for you

HIV+ women respond well to HPV vaccine

2 hours ago

HIV-positive women respond well to a vaccine against the human papillomavirus (HPV), even when their immune system is struggling, according to newly published results of an international clinical trial. The study's findings ...

HIV battle must focus on hard-hit streets, paper argues

Apr 10, 2014

In U.S. cities, it's not just what you do, but also your address that can determine whether you will get HIV and whether you will survive. A new paper in the American Journal of Public Health illustrates the ef ...

User comments : 0

More news stories

US judge overturns state's abortion law

A federal judge on Wednesday overturned a North Dakota law banning abortions when a fetal heartbeat can be detected, as early as six weeks into pregnancy and before many women know they're pregnant.

Meteorites yield clues to Martian early atmosphere

(Phys.org) —Geologists who analyzed 40 meteorites that fell to Earth from Mars unlocked secrets of the Martian atmosphere hidden in the chemical signatures of these ancient rocks. Their study, published ...

Japan lawmakers demand continued whaling

Japanese lawmakers on Wednesday demanded the government redesign its "research" whaling programme to circumvent an international court ruling that described the programme as a commercial hunt dressed up as ...