Extra-spousal partnerships in a community in rural Uganda with high HIV prevalence: a cross-sectional population-based study using linked spousal data.


Kasamba, I; Sully, E; Weiss, HA; Baisley, K; Maher, D; (2011) Extra-spousal partnerships in a community in rural Uganda with high HIV prevalence: a cross-sectional population-based study using linked spousal data. Journal of acquired immune deficiency syndromes (1999). ISSN 1525-4135 DOI: https://doi.org/10.1097/QAI.0b013e318227af4d

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Abstract

BACKGROUND:: The role of concurrent sexual partnerships in the HIV epidemic in sub-Saharan Africa is not well understood. While most infections in Africa occur among married individuals, transmission may occur from both spousal and extra-spousal partnerships. This paper explores extra-spousal partnerships as a form of concurrency, examining the association with HIV status, demographic characteristics and sexual behaviours in a population-based cohort in rural Uganda. METHODS:: Prevalence of extra-spousal partnerships was estimated using cross-sectional data from 2008, and adjusted odds ratios (aOR) were estimated for factors associated with the prevalence of extra-spousal partnerships using logistic regression. Among men who were not in polygynous marriages, we used linked spousal data to investigate the association between extra-spousal partnerships and wives' sero-status. RESULTS:: Extra-spousal partnerships in the past year were reported by 17% of married men and 2% of married women. Among both men and women, extra-spousal partnerships were associated with not knowing their partners' HIV status (Men: aOR=1.74; 95%CI:1.13-2.67; Women: aOR=1.76; 95%CI: 1.13-2.75 ), and extra-spousal partnerships were also associated with increased condom use for men. There was no evidence that men reporting extra-spousal partnerships were at increased risk of HIV (aOR= 0.98; 95%CI: 0.48-2.01), or that a woman's risk of HIV was associated with her husband reporting extra-spousal partnerships (aOR=0.68; 95%CI:0.29-1.57). CONCLUSION:: For both men and women, extra-spousal partnerships were associated with not knowing their partners' HIV status. There was no evidence of an association of extra-spousal partnerships with HIV sero-status in this cross-sectional analysis.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Tropical Epidemiology Group
PubMed ID: 21694606
Web of Science ID: 294610600020
URI: http://researchonline.lshtm.ac.uk/id/eprint/579

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