, Volume 16, Issue 2, pp 304-311
Date: 30 Jan 2011

Neglected Issues and Hypotheses Regarding the Impact of Sexual Concurrency on HIV and Sexually Transmitted Infections

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In the past few years, the relative contribution of concurrent sexual partnerships where partnerships overlap over time (i.e., concurrency) to the HIV epidemic in sub-Saharan Africa, and the need to scale up interventions to reduce concurrency, has been discussed extensively [111]. Theoretically, concurrency enhances HIV transmission compared to serial monogamy because it shortens the time between sexual contacts with different partners and therefore reduces the window period between the acquisition of infection and transmission to other partners. It also removes the protective effect of sequential partnerships since the first partners of an individual cannot be infected by subsequent infected partners of this individual [6]. At the population level, concurrency increases network connectivity and creates larger components than serial monogamy, thus favouring infection transmission [6, 7, 12]. Currently, the evidence that concurrency facilitates HIV spread is mainly based o