AIDS and Behavior

, Volume 18, Issue 12, pp 2457–2468 | Cite as

Prevalence and Predictors of Concurrent Sexual Partnerships in a Predominantly African American Population in Jackson, Mississippi

  • Amy Nunn
  • Sarah MacCarthy
  • Nancy Barnett
  • Jennifer Rose
  • Philip Chan
  • Annajane Yolken
  • Alexandra Cornwall
  • Nicholas Chamberlain
  • Arti Barnes
  • Reginald Riggins
  • Elya Moore
  • Dantrell Simmons
  • Sharon Parker
  • Leandro Mena
Original Paper

Abstract

Concurrent sexual partnerships, or sexual partnerships that overlap in time, have been associated with HIV and sexually transmitted infections (STI). How best to measure concurrency and the personal characteristics and predictors of concurrency are not yet well understood. We compared two frequently used concurrency definitions, including a self-reported measure based on participant response regarding overlapping sex with partners, and the UNAIDS measure based on overlapping dates of last sex and intention to have sex again. We performed multivariable logistic regression analyses to identify socio-demographic, behavioral, and structural predictors of concurrency among 1,542 patients at an urban STI clinic in Jackson, Mississippi. Nearly half (44 %) reported concurrency based on self-reported sex with other partners, and 26 % reported concurrency according to the UNAIDS concurrency measure. Using the self-reported concurrency measure, the strongest predictors of concurrency were perceived partner concurrency, drug use at last sex, having more than 10 lifetime partners, and being recently incarcerated. Strongest predictors of concurrency using the UNAIDS measure were lifetime number of partners and perceived partner concurrency. Concurrency is highly prevalent in this population in the Deep South and social, structural and behavioral factors were important predictors of concurrency for both measures. Future research should use time anchored data collection methods and biomarkers to assess whether both definitions of concurrency are associated with HIV outcomes.

Keywords

HIV African Americans Epidemiology Risk factors Mississippi 

Notes

Acknowledgments

Amy Nunn developed the idea for this paper and led all data collection, data analysis, and writing. Jennifer Rose led statistical analysis and contributed writing for this paper. Sarah MacCarthy, Nancy Barnett, Alexandra Cornwall, Annajane Yolken, Dantrell Simmons, Reginald Riggins, Philip Chan, Nicholas Chamberlain, Sharon Parker, and Elya Moore contributed to the data collection and writing of this paper. Leandro Mena contributed to the study design, data collection analysis, and writing of this paper. This manuscript was supported with NIH Grants K01 020228-01A1, P01 AA019072, K23AI096923, R25MH083620, T32 DA013911, and P30-A1042853.

References

  1. 1.
    CDC. Estimated HIV incidence in the United States, 2007–2010. 2012.Google Scholar
  2. 2.
    Aral SO, Adimora AA, Fenton KA. Understanding and responding to disparities in HIV and other sexually transmitted infections in African Americans. Lancet. 2008;372(9635):337–40.PubMedCrossRefGoogle Scholar
  3. 3.
    Friedman SR, Cooper HL, Osborne AH. Structural and social contexts of HIV risk among African Americans. Am J Public Health. 2009;99(6):1002–8.PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Millett GA, Peterson JL, Flores SA, Hart TA, Jeffries WLT, Wilson PA, et al. Comparisons of disparities and risks of HIV infection in black and other men who have sex with men in Canada, UK, and USA: a meta-analysis. Lancet. 2012;380(9839):341–8.PubMedCrossRefGoogle Scholar
  5. 5.
    CDC. 2010 Sexually Transmitted Diseases Surveillance. Centers for Disease Control; 2011.Google Scholar
  6. 6.
    MSDH. Mississippi State Department of Health HIV/AIDS Surveillance Report, 2004–2008. Jackson; 2008.Google Scholar
  7. 7.
    CDC. Diagnoses of HIV Infection and AIDS in the United States and Dependent Areas, 2010. Centers for Disease Control; 2010.Google Scholar
  8. 8.
    Neaigus A, Jenness SM, Hagan H, Murrill CS, Wendel T. Reciprocal sex partner concurrency and STDs among heterosexuals at high-risk of HIV infection. J Urban Health. 2012;23:23.Google Scholar
  9. 9.
    Adimora AA, Schoenbach VJ, Doherty IA. Concurrent sexual partnerships among men in the United States. Am J Public Health. 2007;97(12):2230–7.PubMedCentralPubMedCrossRefGoogle Scholar
  10. 10.
    Adimora AA, Schoenbach VJ, Taylor EM, Khan MR, Schwartz RJ. Concurrent partnerships, nonmonogamous partners, and substance use among women in the United States. Am J Public Health. 2011;101(1):128–36.PubMedCentralPubMedCrossRefGoogle Scholar
  11. 11.
    Adimora AA, Schoenbach VJ, Martinson FE, Donaldson KH, Stancil TR, Fullilove RE. Concurrent partnerships among rural African Americans with recently reported heterosexually transmitted HIV infection. J Acquir Immune Defic Syndr. 2003;34(4):423–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Laumann EO, Youm Y. Racial/ethnic group differences in the prevalence of sexually transmitted diseases in the United States: a network explanation. Sex Transm Dis. 1999;26(5):250–61.PubMedCrossRefGoogle Scholar
  13. 13.
    Morris M, Kretzschmar M. Concurrent partnerships and transmission dynamics in social networks. Soc Netw. 1995;17:299–318.CrossRefGoogle Scholar
  14. 14.
    Garnett GP, Johnson AM. Coining a new term in epidemiology: concurrency and HIV. Aids. 1997;11(5):681–3.PubMedCrossRefGoogle Scholar
  15. 15.
    Adimora AA, Schoenbach VJ, Bonas DM, Martinson FE, Donaldson KH, Stancil TR. Concurrent sexual partnerships among women in the United States. Epidemiology. 2002;13(3):320–7.PubMedCrossRefGoogle Scholar
  16. 16.
    Nelson SJ, Manhart LE, Gorbach PM, Martin DH, Stoner BP, Aral SO, et al. Measuring sex partner concurrency: it’s what’s missing that counts. Sex Transm Dis. 2007;34(10):801–7.PubMedGoogle Scholar
  17. 17.
    UNAIDS. HIV: consensus indicators are needed for concurrency. Lancet. 2010;375(9715):621–2.CrossRefGoogle Scholar
  18. 18.
    Kenyon C, Colebunders B. Role of concurrency in generalised HIV epidemics. Lancet. 2011;378(9806):1844. doi: 10.1016/S0140-6736(11)61804-7.PubMedCrossRefGoogle Scholar
  19. 19.
    Glynn JR, Dube A, Kayuni N, Floyd S, Molesworth A, Parrott F, et al. Measuring concurrency: an empirical study of different methods in a large population-based survey and evaluation of the UNAIDS guidelines. Aids. 2012;26(8):977–85.PubMedCrossRefGoogle Scholar
  20. 20.
    WHO. Closing the gap in a generation: health equity through action on the social determinants of health. Geneva: World Health Organization; 2008.Google Scholar
  21. 21.
    Nunn A, Dickman S, Cornwall A, Rosengard C, Kwakwa H, Kim D, et al. Social, structural and behavioral drivers of concurrent partnerships among African American men in Philadelphia. AIDS Care. 2011;23(11):1392–9.PubMedCentralPubMedCrossRefGoogle Scholar
  22. 22.
    Nunn A, Dickman S, Cornwall A, Kwakwa H, Mayer KH, Rana A, et al. Concurrent sexual partnerships among African American women in Philadelphia: results from a qualitative study. Sex Health. 2012;9(3):288–96.PubMedCentralPubMedCrossRefGoogle Scholar
  23. 23.
    Tsui EK, Leonard L, Lenoir C, Ellen JM. Poverty and sexual concurrency: a case study of STI risk. J Health Care Poor Underserved. 2008;19(3):758–77.PubMedCrossRefGoogle Scholar
  24. 24.
    Taylor EM, Behets FM, Schoenbach VJ, Miller WC, Doherty IA, Adimora AA. Coparenting and sexual partner concurrency among white, black, and Hispanic men in the United States. Sex Transm Dis. 2011;38(4):293–8.PubMedGoogle Scholar
  25. 25.
    Khan MR, Doherty IA, Schoenbach VJ, Taylor E, Epperson M, Adimora AA. Incarceration and high-risk sex partnerships among men in the United States. J Urban Health. 2009;86(4):584–601.PubMedCentralPubMedCrossRefGoogle Scholar
  26. 26.
    Khan MR, Behrend L, Adimora AA, Weir SS, Tisdale C, Wohl DA. Dissolution of primary intimate relationships during incarceration and associations with post-release STI/HIV risk behavior in a Southeastern city. Sex Transm Dis. 2011;38(1):43–7.PubMedCentralPubMedCrossRefGoogle Scholar
  27. 27.
    Grieb SM, Davey-Rothwell M, Latkin CA. Social and sexual network characteristics and concurrent sexual partnerships among urban African American high-risk women with main sex partners. AIDS Behav. 2012;16(4):882–9.PubMedCrossRefGoogle Scholar
  28. 28.
    Grieb SM, Davey-Rothwell M, Latkin CA. Concurrent sexual partnerships among urban African American high-risk women with main sex partners. AIDS Behav. 2012;16(2):323–33.PubMedCentralPubMedCrossRefGoogle Scholar
  29. 29.
    Drumright LN, Gorbach PM, Holmes KK. Do people really know their sex partners? Concurrency, knowledge of partner behavior, and sexually transmitted infections within partnerships. Sex Transm Dis. 2004;31(7):437–42.PubMedCrossRefGoogle Scholar
  30. 30.
    Alexandra M, Oster M, Christina G, Dorell MD, et al. HIV risk among young African American men who have sex with men: a case-control study in Mississippi. Am J Public Health. 2011;101(1):137–43.CrossRefGoogle Scholar
  31. 31.
    Carey MP, Senn TE, Seward DX, Vanable PA. Urban African-American men speak out on sexual partner concurrency: findings from a qualitative study. AIDS Behav. 2008;21:153–61.Google Scholar
  32. 32.
    Gorbach PM, Stoner BP, Aral SO, Whittington WL, Holmes KK. It takes a village: understanding concurrent sexual partnerships in Seattle, Washington. Sex Transm Dis. 2002;29(8):453–62.PubMedCrossRefGoogle Scholar
  33. 33.
    Adimora AA, Schoenbach VJ. Contextual factors and the black-white disparity in heterosexual HIV transmission. Epidemiology. 2002;13(6):707–12.PubMedCrossRefGoogle Scholar
  34. 34.
    Manhart LE, Aral SO, Holmes KK, Foxman B. Sex partner concurrency: measurement, prevalence, and correlates among urban 18–39-year-olds. Sex Transm Dis. 2002;29(3):133–43.PubMedCrossRefGoogle Scholar
  35. 35.
    Adimora AA, Schoenbach VJ, Martinson F, Donaldson KH, Stancil TR, Fullilove RE. Concurrent sexual partnerships among African Americans in the rural south. Ann Epidemiol. 2004;14(3):155–60.PubMedCrossRefGoogle Scholar
  36. 36.
    Adimora AA, Schoenbach VJ, Doherty IA. HIV and African Americans in the southern United States: sexual networks and social context. Sex Transm Dis. 2006;33(7 Suppl):S39–45.PubMedCrossRefGoogle Scholar
  37. 37.
    Carael M, Kretzschmar M. Measuring concurrent partnerships: back on track. AIDS. 2012;26(8):1027–9. doi: 10.1097/QAD.0b013e3283522d6b.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Amy Nunn
    • 1
  • Sarah MacCarthy
    • 1
  • Nancy Barnett
    • 2
  • Jennifer Rose
    • 3
  • Philip Chan
    • 1
  • Annajane Yolken
    • 1
  • Alexandra Cornwall
    • 1
  • Nicholas Chamberlain
    • 3
  • Arti Barnes
    • 4
  • Reginald Riggins
    • 1
    • 5
  • Elya Moore
    • 6
  • Dantrell Simmons
    • 1
    • 5
  • Sharon Parker
    • 1
  • Leandro Mena
    • 4
  1. 1.Division of Infectious DiseasesThe Miriam Hospital and The Warren Alpert School of Medicine at Brown UniversityProvidenceUSA
  2. 2.Department of Behavioral and Social Sciences, Center for Alcohol and Addiction StudiesBrown UniversityProvidenceUSA
  3. 3.Department of PsychologyWesleyan UniversityMiddletownUSA
  4. 4.Division of Infectious DiseasesUniversity of Mississippi Medical CenterJacksonUSA
  5. 5.Jackson State UniversityJacksonUSA
  6. 6.Whatcom Alliance for Healthcare AccessBellinghamUSA

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