Measuring concurrency: an empirical study of different methods in a large population-based survey and evaluation of the UNAIDS guidelines.


Glynn, JR; Dube, A; Kayuni, N; Floyd, S; Molesworth, A; Parrott, F; French, N; Crampin, AC; (2012) Measuring concurrency: an empirical study of different methods in a large population-based survey and evaluation of the UNAIDS guidelines. AIDS (London, England), 26 (8). pp. 977-85. ISSN 0269-9370 DOI: https://doi.org/10.1097/QAD.0b013e328350fc1f

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Abstract

BACKGROUND: : Recent UNAIDS guidelines recommend measuring concurrency 6 months before the interview date, based on overlapping partnership dates. This has theoretical advantages, but little is known about how well it can be measured in practice. METHODS: : The assumptions underlying the UNAIDS measure were tested using data from a sexual behaviour survey conducted in rural northern Malawi. All resident adults aged 15-59 were eligible. Questions included self-reported concurrency and dates for all marital and nonmarital partnerships in the past 12 months. RESULTS: : A total of 6796 women and 5253 men were interviewed, 83 and 72% of those eligible, respectively. Since few women reported multiple partners, detailed analysis was restricted to men. Overall 19.2% [95% confidence interval (CI) 18.1-20.2] of men self-reported concurrent relationships in the past year (almost all of those with more than one partner). Using overlapping dates the estimate was 16.7% (15.7-17.7). Excluding partnerships which tied on dates (making overlap uncertain) or restricting the analysis to the three most recent partners gave similar results. The UNAIDS 6-month measure was 12.0% (11.1-12.9), and current concurrency was 11.5% (10.6-12.4). The difference between dates-based and self-reported 12-month measures was much larger for unmarried men: 11.1% (9.7-12.4) self-reported; 7.1% (6.9-8.2) on dates. Polygyny (15% of married men) and the longer duration of relationships stabilized the estimates for married men. Nonmarital partnerships were under-reported, particularly those starting longer ago. CONCLUSIONS: : The difficulties of recall of dates for relationships, and under-reporting of partners lead to underestimation of concurrency using date-based measures. Self-reported concurrency is much easier to measure and appears more complete.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: ALPHA Network
MEIRU
Population Studies Group
Tropical Epidemiology Group
PubMed ID: 22555149
Web of Science ID: 303656000009
URI: http://researchonline.lshtm.ac.uk/id/eprint/21022

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