Serial Monogamy and Biologic Concurrency: Measurement of the Gaps Between Sexual Partners to Inform Targeted Strategies

Abstract

Having multiple sexual partners concurrently increases the risk of transmission of a sexually transmitted infection. Even if partnerships do not overlap, transmission potential exists when the gap between partnerships is shorter than the remaining infectious period. In the present article, we quantify the gap between partners to assess transmission potential using data collected by a cross-sectional survey of 2,203 genitourinary medicine clinic patients in England in 2009. Questionnaires asked about patients' 3 most recent partnerships. Gaps were calculated as time (days) between the last sexual encounter with a former partner and the first sexual encounter with the next partner. Among 1,875 patients who reported 1 or more partners in the previous 3 months, 47.6% of men and 27.7% of women reported 2 or more partners. Forty-two percent of the gaps were negative (i.e., partnerships that were concurrent); the median gaps were -7 and -17 days for men and women, respectively (i.e., overlaps were 7 and 17 days for men and women, respectively). Although half of the gaps were positive (serially monogamous partnerships), many were of short duration; the median gaps were 14 and 24 days for men and women, respectively. In over half of the gaps, condoms were used inconsistently with one or both partners, and in one-quarter, condoms were never used with either partner. There is thus a high potential for sexually transmitted infections, as even if partnerships are not behaviorally concurrent, they may be biologically concurrent. These data have important implications for designing and targeting effective health promotion messages.

The Role of Drinking Places in Enhancing Risky Sexual Behaviours and the Spread of HIV/AIDS amongst the Tiv People of Benue State, Central Nigeria

“…There are joints for drinking of alcohol, meeting new sexual partners, negotiations for illicit sex, verbal pornography that increases the desire for sex, and open conflict due to scramble for sexual partners. Serial multiple partnerships with short gaps initiated at drinking places constitutes high risk, sexual behaviours, hence recently infected partners can expose the other to the danger of infection especially where probability of transmission are highest [24]. However, previous studies in Nigeria have not given attention to the contributions of these places to the problem of illicit sexual behaviours and a higher incidence of HIV infection in the study area, and the country at large.…”

Sexual Partnership Patterns Among South African Adolescent Girls Enrolled in STI Preventions Trial Network 068

“…Among sets of non-concurrent partnerships, we calculated crude gap length by taking the difference between the date of most recent sex for the earlier partner (MR 1 ) and the date of first sex for the newer partner (F 2 ) (where “earlier” vs. “newer” is determined by the date of first sex) (Figure 1E–1H). Among concurrent partnerships, we calculated crude overlap length following methods outlined in Powers et al (15) and Mercer et al (20). If the partnerships were partially contained (i.e.…”

“…Serially monogamous partnerships can facilitate HIV/STI transmission if the gap length between partnerships is shorter than the remaining, highly infectious early HIV infection period or shorter than the remaining infectious period for an STI (18, 20). We explored the potential for transmission by short gap lengths between serially monogamous partnerships by estimating the percentage of partnership gaps that were shorter than 3, 6, 9, 12, and 24 months, choosing these cut points to approximate infectious periods of common STIs and the early HIV infection period.…”

“…Sexual partnerships are commonly defined as the time between date of first sex (partnership start) and date of last sex (partnership end) (15–20, 22). The date of partnership end can be difficult to establish if a partnership is ongoing at the time of data collection because the respondent can only provide the date of most recent sex (i.e., the date she/he last had sex with the partner before the interview), not the date of true last sex.…”

Characteristics of African American Women and Their Partners With Perceived Concurrent Partnerships in 4 Rural Counties in the Southeastern US

“…Relative to serial sexual partnerships, concurrent sexual partnerships, or partnerships that overlap in time, can accelerate the spread of HIV infection (2). To the individual with concurrent partners, having concurrent partnerships likely confers no greater risk of acquiring an STI than having multiple consecutive partnerships (3, 4). However, an individual whose partner has concurrent partnerships (i.e., partners' concurrency) is at increased risk of incident STI (5, 6), as the partner may be in other sexual networks with higher STI prevalence (7).…”