Abstract
One of the major goals of couple-based HIV prevention programs in sub-Saharan Africa is to reduce outside sex partners, known as sexual concurrency. This cross-sectional study examined sexual concurrency at the couple-level and differentiated couples based on whether neither, one, or both partners engaged in sexual concurrency over the past 6 months. Individual predictors (alcohol use and lifetime history of physical or sexual trauma) and relationship predictors (mistrust, relationship inequity, relationship satisfaction, and sexual satisfaction) were used as predictors of couple-level sexual concurrency. A quantitative investigation using path analysis was carried out with data collected from 286 South African heterosexual couples. Results showed that alcohol use for both sexes, relationship dissatisfaction for women, and mistrust among women were predictive of different types of sexual concurrency. Findings suggest that consideration of the experiences and behavior of both partners may be useful in understanding different reasons for engagement in sexual concurrency.
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Notes
N = 290 couples began the baseline interview but four men completed demographic information only. These four men and women were removed from the analyses.
We initially constructed latent variables for all variables in the model that had more than two indicators. These latent variables were subsequently used in hypothesis testing, although the model became analytically intractable with the number of latent variables required. We ran models with a combination of manifest and latent variables in an attempt to reduce model complexity while retaining the measurement advantages offered by latent variables. Results from those models do not substantively differ from the models presented here that include manifest variables only; where differences do occur, readers are informed throughout the text. Results of analyses with latent variables can be obtained from the first author.
All model covariances are provided in the supplemental Tables S2–S4.
In the analogous latent variable model, women’s relationship satisfaction was not a significant predictor of couple-level sexual concurrency.
In the analogous latent variable model, men’s alcohol use did not retain its significance as a predictor of couple-level sexual concurrency.
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Acknowledgements
This study is based on the doctoral dissertation of Jennifer Belus at the University of North Carolina under the direction of Donald H. Baucom. This study was funded by National Institute on Alcohol Abuse and Alcoholism, Grant No. R01 AA018076. PI: Wendee M. Wechsberg.
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Belus, J.M., Baucom, D.H. & Wechsberg, W.M. Individual and Relationship Predictors of Couple-Level Sexual Concurrency in Heterosexual South African Couples. Arch Sex Behav 49, 999–1015 (2020). https://doi.org/10.1007/s10508-019-1444-3
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DOI: https://doi.org/10.1007/s10508-019-1444-3