Fleming, P. J., Mulawa, M., Burke, H., et al. AIDS Care (October 2014), E-publication ahead of print.
Multiple concurrent partnerships are considered one of the important drivers of HIV transmission. This study examined how different combinations of concurrent partnerships (with a wife, girlfriend, casual partner, and/or sex worker in various combinations) affect condom use. The authors looked at survey data from a sample of heterosexual men aged 18–49 years from Ghana (n = 807) and Tanzania (n = 800) who had at least three sexual partners in the last three months before the study. Each man self-reported condom use at last vaginal sex for each of his last three partners. Study participants reported 34 (Ghana) and 32 (Tanzania) relationship type combinations, the most prevalent being three girlfriends (GH: 37.5 percent of men; TZ: 34.8 percent of men). The authors focused on condom use with girlfriends, since this was the only relationship type with a sufficient sample size. In both countries, men viewed a girlfriend as a steady partner. The study found that men were more likely to use a condom with a girlfriend if their other partner was a wife than if the partner was a sex worker. The authors concluded that condom use seems to be associated with the types of partners that comprise men’s concurrent relationships. More research is needed to see how different combinations of relationships influence HIV risk behaviors and condom use.