Characteristics of Multiple and Concurrent Partnerships Among Women At High Risk for HIV Infection

Adimora, Adaora A. MD, MPH*; Hughes, James P. PhD†,‡; Wang, Jing MS; Haley, Danielle F. MPH§; Golin, Carol E. MD*; Magnus, Manya PhD, MPH; Rompalo, Anne MD, ScM; Justman, Jessica MD#; Rio, Carlos del MD**; El-Sadr, Wafaa MD, MPH#; Mannheimer, Sharon MD††; Soto-Torres, Lydia MD, MPH‡‡; Hodder, Sally L. MD§§; for the HPTN 064 Protocol Team

JAIDS Journal of Acquired Immune Deficiency Syndromes:
doi: 10.1097/QAI.0b013e3182a9c22a
Epidemiology and Prevention
Abstract

Objectives: We examined parameters of sexual partnerships, including respondents’ participation in concurrency, belief that their partner had concurrent partnerships (partners’ concurrency), and partnership intervals, among the 2099 women in HIV Prevention Trials Network 064, a study of women at high risk for HIV infection, in 10 U.S. communities.

Methods: We analyzed baseline survey responses about partnership dates to determine prevalence of participants’ and partners’ concurrency, intervals between partnerships, knowledge of whether recent partners had undergone HIV testing, and intercourse frequency during the preceding 6 months.

Results: Prevalence of participants’ and partners’ concurrency was 40% and 36%, respectively; 24% respondents had both concurrent partnerships and nonmonogamous partners. Among women with >1 partner and no concurrent partnerships themselves, the median gap between partners was 1 month. Multiple episodes of unprotected vaginal intercourse with ≥2 of their most recent partners was reported by 60% of women who had both concurrent partnerships and nonmonogamous partners, 50% with only concurrent partners and no partners’ concurrency, and 33% with only partners’ concurrency versus 14% of women with neither type of concurrency (P < 0.0001). Women who had any involvement with concurrency were also more likely than women with no concurrency involvement to report lack of awareness of whether recent partners had undergone HIV testing (participants’ concurrency 41%, partners’ concurrency 40%, both participants’ and partners’ concurrency 48%, neither 17%; P < 0.0001).

Conclusions: These network patterns and short gaps between partnerships may create substantial opportunities for HIV transmission in this sample of women at high risk for HIV infection.

Author Information

*Division of Infectious Diseases, University of North Carolina Schools of Medicine and UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC;

Department of Biostatistics, University of Washington, Seattle, WA;

Fred Hutchinson Cancer Research Center, Seattle, WA;

§FHI 360, Durham, NC;

School of Public Health and Health Services, The George Washington University, Washington, DC;

Johns Hopkins University School of Medicine, Baltimore, MD;

#ICAP-Columbia University, Mailman School of Public Health, Columbia University, New York, NY;

**Rollins School of Public Health and Center for AIDS Research, Emory University, Atlanta, GA;

††Harlem Hospital Center, New York, NY;

‡‡NIAID, NIH, Bethesda, MD; and

§§Rutgers, The State University of New Jersey, Newark, NJ.

Correspondence to: Adaora A. Adimora, MD, MPH, Division of Infectious Diseases, 130 Mason Farm Road, CB #7030, UNC School of Medicine, Chapel Hill, NC (e-mail: adimora@med.unc.edu).

Supported by the National Institute of Allergy and Infectious Diseases, National Institute on Drug Abuse, and National Institute of Mental Health (cooperative agreement no. UM1 AI068619, U01-AI068613, and UM1-AI068613); National Institute of Child Health and Human Development (5 K24HD059358-02); Centers for Innovative Research to Control AIDS, Mailman School of Public Health, Columbia University (5U1Al069466); University of North Carolina Clinical Trials Unit (AI069423); University of North Carolina Clinical Trials Research Center of the Clinical and Translational Science Award (RR 025747); University of North Carolina Center for AIDS Research (AI050410); Emory University HIV/AIDS Clinical Trials Unit (5UO1AI069418), Center for AIDS Research (P30 AI050409), and Clinical and Translational Science Award (UL1 RR025008); The Terry Beirn Community Programs for Clinical Research on AIDS Clinical Trials Unit(5 UM1 AI069503-07); and The Johns Hopkins Adult AIDS Clinical Trial Unit (AI069465) and The Johns Hopkins Clinical and Translational Science Award (UL1 RR 25005).

The views expressed herein are solely the responsibility of the authors and do not necessarily represent the official views of the National Institute of Allergy and Infectious Diseases, the National Institute of Mental Health, the National Institutes of Health, the HPTN, or its funders.

The authors have no conflicts of interest to disclose.

Received April 01, 2013

Accepted July 23, 2013

© 2014 by Lippincott Williams & Wilkins