Gender Differences in the Risk of HIV Infection Among Persons Reporting Abstinence, Monogamy, and Multiple Sexual Partners in Northern Tanzania
Landman, K. Z., Ostermann, J., Crump, J. A., et al. PLoS ONE (2008), 3(8), p. e3075.
Data from over 6,500 clients attending a HIV testing and counseling center in northern Tanzania between November 2003 and December 2007 found that one-fourth of females and one-tenth of males seeking testing were living with HIV. As expected, an increased number of sexual partners was associated with increased risk for seropositivity for men and women alike. Monogamous women who reported that their partner had other sex partners (or did not know) were 36 percent more likely to be infected with HIV than a monogamous woman whose partner was also monogamous. Furthermore, monogamous women were more likely than monogamous men to become infected with HIV. Despite study limitations, the authors concluded that their research demonstrates the limited protection of monogamy for women and highlights the role of male partner concurrency in infecting women. The authors suggest that the “overly simple formulation” of the ABC prevention strategy (if not abstinence, then be faithful, and if not faithful, then use condoms) is misguided. They argue that HIV prevention efforts that promote abstinence, partner reduction, and mutual monogamy take place concurrently with efforts to empower women to “better control their exposure risk.”