Researchers question evidence linking overlapping sexual partners and African HIV rates

October 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)

Related Stories

Recommended for you

Three-in-one antibody protects monkeys from HIV-like virus

September 20, 2017
A three-pronged antibody made in the laboratory protected monkeys from infection with two strains of SHIV, a monkey form of HIV, better than individual natural antibodies from which the engineered antibody is derived, researchers ...

Fighting HIV on multiple fronts might lead to vaccine

September 20, 2017
A combination antibody strategy could be the key to halting the spread of HIV, according to results from two promising animal studies.

HIV-AIDS: Following your gut

September 18, 2017
Researchers at the University of Montreal Hospital Research Centre (CRCHUM) have discovered a way to slow viral replication in the gastrointestinal tract of people infected by HIV-AIDS.

Study finds cutbacks in foreign aid for HIV treatment would cause great harm

August 30, 2017
Proposed reductions in U.S. foreign aid would have a devastating impact on HIV treatment and prevention programs in countries receiving such aid, an international team of investigators reports. In their paper published online ...

Cancer drug can reactivate HIV

August 24, 2017
People living with HIV must take a combination of three or more different drugs every day for the rest of their lives. Unfortunately, by following this strict treatment plan, they can suffer from side effects ranging from ...

New injectable antiretroviral treatment proved to be as effective as standard oral therapy

August 3, 2017
Intramuscularly administered antiretroviral therapy (ART) may be as effective for HIV treatment as current oral therapies. This is the main conclusion of a Phase II clinical trial carried out by 50 research centers around ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.