Advertisement

Coital Frequency and Male Concurrent Partnerships During Pregnancy and Postpartum in Agbogbloshie, Ghana

  • Susan CasselsEmail author
  • Samuel M. Jenness
  • Adriana A. E. Biney
Original Paper
  • 46 Downloads

Abstract

During pregnancy and postpartum, women in high HIV prevalence regions continue to be at high risk for acquiring HIV, due to both behavioral and biological mechanisms, despite declines in coital frequency as a pregnancy advances. We estimated differences in rates of partnership concurrency for men with and without pregnant or postpartum sexual partners. We used monthly retrospective panel data from Ghana from three perspectives: couple-level data, female reports of pregnancy and male partner concurrency, and male reports of concurrent partnerships and female partner pregnancy. Coital frequency increased during the first trimester and then declined with advancing pregnancy. However, in all three analyses, there was no compelling evidence that men with pregnant or postpartum partners had additional concurrent partnerships. Our findings suggest that even though women’s sexual activity likely declines during pregnancy and postpartum, they may not be at increased risk of HIV/STI due to their partners seeking additional partnerships.

Keywords

HIV/STI Multiple concurrent partnerships Agbogbloshie Pregnant Postpartum 

Notes

Acknowledgements

This material is supported by funding from the NICHD K99/R00 HD057533. We acknowledge Dr. Francis Dodoo from The Pennsylvania State University and the University of Ghana, along with the Migration and HIV in Ghana study staff and others at the Regional Institute for Population Studies for their support. In addition, we would like to thank Ayme Tomson and Rafael Melendez-Rios for their work on this project through the NSF Network Science IGERT at the University of California Santa Barbara.

Compliance with Ethical Standards

Conflict of interest

Drs. Cassels, Jenness, and Biney declare that we have no conflict of interest.

Ethical Approval

The Institutional Review Boards of the University of Washington and the Noguchi Memorial Institute for Medical Research, University of Ghana, approved the study protocols. Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Drake AL, Wagner A, Richardson B, John-Stewart G. Incident HIV during pregnancy and postpartum and risk of mother-to-child HIV transmission: a systematic review and meta-analysis. PLoS Med. 2014;11(2):e1001608.CrossRefGoogle Scholar
  2. 2.
    Gray RH, Li X, Kigozi G, Serwadda D, Brahmbhatt H, Wabwire-Mangen F, et al. Increased risk of incident HIV during pregnancy in Rakai, Uganda: a prospective study. Lancet. 2005;366(9492):1182–8.CrossRefGoogle Scholar
  3. 3.
    Kinuthia J, Drake AL, Matemo D, Richardson BA, Zeh C, Osborn L, et al. HIV acquisition during pregnancy and postpartum is associated with genital infections and partnership characteristics. AIDS. 2015;29(15):2025–33.CrossRefGoogle Scholar
  4. 4.
    Kinuthia J, Kiarie JN, Farquhar C, Richardson B, Nduati R, Mbori-Ngacha D, et al. Cofactors for HIV-1 incidence during pregnancy and postpartum period. Curr HIV Res. 2010;8(7):510–4.CrossRefGoogle Scholar
  5. 5.
    Moodley D, Esterhuizen TM, Pather T, Chetty V, Ngaleka L. High HIV incidence during pregnancy: compelling reason for repeat HIV testing. AIDS. 2009;23(10):1255–9.CrossRefGoogle Scholar
  6. 6.
    Thomson KA, Hughes J, Baeten JM, John-Stewart G, Celum C, Cohen CR, et al. Increased risk of HIV acquisition among women throughout pregnancy and during the postpartum period: a prospective per-coital-act analysis among women with hiv-infected partners. J Infect Dis. 2018;218(1):16–25.CrossRefGoogle Scholar
  7. 7.
    Hapgood JP, Kaushic C, Hel Z. Hormonal contraception and HIV-1 acquisition: biological mechanisms. Endocr Rev. 2018;39(1):36–78.CrossRefGoogle Scholar
  8. 8.
    Goodreau S, Morris M. Concurrency Tutorials 2012. http://www.statnet.org/concurrency.
  9. 9.
    UNAIDS Reference Group. HIV: consensus indicators are needed for concurrency. Lancet. 2010;375(9715):621–2.CrossRefGoogle Scholar
  10. 10.
    Eaton JW, Hallett TB, Garnett GP. Concurrent sexual partnerships and primary HIV infection: a critical interaction. AIDS Behav. 2011;15(4):687–92.CrossRefGoogle Scholar
  11. 11.
    Goodreau SM, Cassels S, Kasprzyk D, Montano DE, Greek A, Morris M. Concurrent partnerships, acute infection and HIV epidemic dynamics among young adults in Zimbabwe. AIDS Behav. 2012;16(2):312–22.CrossRefGoogle Scholar
  12. 12.
    Leung KY, Kretzschmar M. Concurrency can drive an HIV epidemic by moving R0 across the epidemic threshold. AIDS. 2015;29(9):1097–103.CrossRefGoogle Scholar
  13. 13.
    Morris M, Kurth AE, Hamilton DT, Moody J, Wakefield S. Concurrent partnerships and HIV prevalence disparities by race: linking science and public health practice. Am J Public Health. 2009;99(6):1023–31.CrossRefGoogle Scholar
  14. 14.
    Lurie MN, Rosenthal S. Concurrent partnerships as a driver of the HIV Epidemic in sub-Saharan Africa? The evidence is limited. AIDS Behav. 2010;14(1):17–24; discussion 5–8.Google Scholar
  15. 15.
    Tanser F, Barnighausen T, Hund L, Garnett GP, McGrath N, Newell ML. Effect of concurrent sexual partnerships on rate of new HIV infections in a high-prevalence, rural South African population: a cohort study. Lancet. 2011;378(9787):247–55.CrossRefGoogle Scholar
  16. 16.
    Cassels S, Jenness SM, Biney AA, Ampofo WK, Dodoo FN. Migration, sexual networks, and HIV in Agbogbloshie, Ghana. Demogr Res. 2014;31:861–88.CrossRefGoogle Scholar
  17. 17.
    Ghana AIDS Commission. National and Sub-National HIV and AIDS Estimates and Projections. 2017.Google Scholar
  18. 18.
    Lawoyin TO, Larsen U. Male sexual behaviour during wife’s pregnancy and postpartum abstinence period in Oyo State, Nigeria. J Biosoc Sci. 2002;34(1):51–63.Google Scholar
  19. 19.
    Onah HE, Iloabachie GC, Obi SN, Ezugwu FO, Eze JN. Nigerian male sexual activity during pregnancy. Int J Gynaecol Obstet. 2002;76(2):219–23.CrossRefGoogle Scholar
  20. 20.
    Jenness SM, Biney AA, Ampofo WK, Nii-Amoo Dodoo F, Cassels S. Minimal coital dilution in Accra, Ghana. J Acquir Immune Defic Syndr. 2015;69(1):85–91.CrossRefGoogle Scholar
  21. 21.
    The World Health Organization (WHO). Preventing HIV during pregnancy and breastfeeding in the context of PrEP. Geneva, Switzerland 2017.10.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of GeographyUniversity of California, Santa BarbaraSanta BarbaraUSA
  2. 2.Department of Epidemiology, Rollins School of Public HealthEmory UniversityAtlantaUSA
  3. 3.Regional Institute for Population StudiesUniversity of GhanaLegonGhana

Personalised recommendations