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Separation of Spouses due to Travel and Living Apart Raises HIV Risk in Tanzanian Couples

Vissers, Debby C.J. MSc*; Voeten, Hélène A.C.M. PhD*; Urassa, Mark MSc; Isingo, Raphael MSc; Ndege, Milalu; Kumogola, Yusufu; Mwaluko, Gabriel PhD; Zaba, Basia MSc†§; de Vlas, Sake J. PhD*; Habbema, J Dik F. PhD*

Sexually Transmitted Diseases: August 2008 - Volume 35 - Issue 8 - p 714-720
doi: 10.1097/OLQ.0b013e3181723d93

Background: Persons with absent partners may be more vulnerable to risky sexual behavior and therefore HIV. Partner absence can be due to traveling (e.g., family visits or funerals) or to living apart (e.g., work-related or in polygamous marriages). We investigated to what extent partner absence leads to more risky sexual behavior in Tanzanian couples.

Methods: We compared 95 men and 85 women living apart with 283 men and 331 women living together. Only persons who were still married were included, either living apart or cohabiting at the time of the interview. Subjects were classified into 4 groups: coresidents being either nonmobile or mobile, and people living apart either frequently or infrequently seeing each other.

Results: Most people living apart were polygamously married. Men living apart did not report more extramarital sex than coresident men. However, among coresident men, extramarital sex was reported by 35% of those being mobile compared with 15% of those nonmobile. Among women, those living apart reported extramarital sex more often than coresidents (14% vs. 7%), and this was mainly due to women living apart who infrequently saw their husbands.

Conclusions: Risky sexual behavior occurs more often in mobile coresident men, and in women living apart infrequently seeing their spouses. These groups are relatively easy to identify and need extra attention in HIV prevention campaigns.

Among Tanzanian couples who live separated, only mobile coresident men, and women living apart and infrequently seeing their spouses, report significantly increased risky sexual behavior.

From the *Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands; †National Institute for Medical Research, Mwanza, Tanzania; ‡Tanzania Netherlands Support on HIV/AIDS Control (TANESA), Mwanza, Tanzania; and §Centre for Populations Studies, London School of Hygiene and Tropical Medicine, London, UK

The authors thank the directors and team members of the National Institute for Medical Research and the TANESA program, based in Mwanza, Tanzania, for their support and assistance in carrying out this study. The authors thank the colleagues from the London School of Hygiene and Tropical Medicine for their contribution to the study. The authors also thank Caspar Looman for statistical advice.

Supported by a grant from the European Union (Grant no. B7.6211/99/010).

Correspondence: Debby C.J. Vissers, MSc, Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. E-mail:

Received for publication October 24, 2007, and accepted February 29, 2008.

© Copyright 2008 American Sexually Transmitted Diseases Association