Ministry of health and child welfare 2008 zimbabwe national hiv prevention strategy document. This study, by determining socioeconomic correlates of multiple sexual partnerships among formerly married men in zimbabwe, will contribute to the. Behavior change behind huge decline in hiv rates in zimbabwe. The hivaids pandemic is an urgent health and growing humanitarian crisis, especially in the highprevalence regions of subsaharan africa where most new infections continue to occur. Concurrent sexual partnerships among married zimbabweans. Concurrent sexual partnerships, with two or more partners, are common practices in africa. Although concurrent sexual partnerships may play an important role in hiv. Hiv is a member of the genus lentivirus, part of the family retroviridae. What emerges clearly from the whogpa data is that multiple concurrent partnerships are frequent in africa. Married couples are at an increased risk of contracting hiv from sexual networks produced by. Students in zimbabwe are said to be sexually active from as early as. This kind of cultural briefs leaves the woman whose man is having multiple concurrent partners with self pity and self blame.
Hiv is different in structure from other retroviruses. Multiple and concurrent partnerships mcps occur when a person is involved in more than one sexual partnership at the same time. Oct 05, 2011 in the era of hiv and aids, the inequality of men and women is fueling the spreading of the epidemic as multiple concurrent partnerships are the order of the day with younger women going for older men even outside the institution of marriage as a means of survival, where these young women have lesser power to negotiate for safer sex. Multiple concurrent partnerships among men and women. Pdf trends in concurrency, polygyny, and multiple sex.
It is composed of two copies of positivesense singlestranded rna that codes for the viruss nine genes enclosed by a conical capsid composed of 2,000 copies of the viral protein p24. The o icheke multiple concurrent partnership campaign was positively viewed as playing a key role in addressing the apparent knowledge gap regarding the impacts of these partnerships and in changing peoples attitudes towards mcp and discouraging wide sexual networks. Concurrent sexual partnership an overview sciencedirect. Mozambique is one of several countries where psi is addressing the phenomenon of multiple concurrent partnerships mcp, known to be an important factor in the high hiv prevalence in eastern and southern africa. Fhi 360 uses sbcc to build partnerships between women and men and transform attitudes and beliefs about gender that fuel the epidemic. Created by the iud subcommittee of usaids maximizing access and quality initiative. According to the joint united nations programme on hivaids unaids in 2016, lesothos adult prevalence rate of 25% is the second. In some parts of africa, where over twothirds of infections occur globally, hiv has expanded outside these highrisk groups, creating generalized, predominantly heterosexual. Women and hiv in subsaharan africa aids research and. Created by k4health and the global health knowledge collaborative.
The critics, writing in the journals aids and behavior and the lancet, argue that researchers lack a precise definition of concurrency or a standard way to measure it, and that the data do not show a significant. The study segmented this group in terms of region, sex and income. Contributions of proximate causes to the hiv decline in zimbabwe. In this commentary, individual, social, economic, and cultural factors underlying multiple concurrent partnerships are discussed.
Mc is a biomedical intervention that is safe, effective, and ready to be put to work in severely affected regions. Factors that contribute to mcps among young people may include lack of communication. Our analysis focused specifically on beliefs about how relationship factors influence. Multiple and concurrent partnerships mcps increase risk. What impact do multiple concurrent sexual partnerships. Addressing multiple and concurrent sexual partnerships in generalized hiv. In addition, zimbabwe has one of the highest rates of orphaning in the world. Reducing multiple concurrent partnerships in mozambique. The strength of the evidence linking concurrency to hiv epidemic severity in southern and eastern africa led the joint united nations programme on hivaids and the southern african development community in 2006 to conclude that high rates of concurrent sexual partnerships, combined with low rates of male circumcision and infrequent condom use, are major drivers of the. Multiple concurrent partnerships among men and women aged. Nov 26, 2008 multiple concurrent partnerships provide a compelling, if partial, resolution of the apparent paradox of africas high hiv infection rates. Full text concurrent sexual partnerships among married. Goodreau s, cassels s, kasprzyk d, montano d, greek a, morris m.
For example, it has been argued that the migrant labour system, imposed under colonial. A youth hiv prevention campaign addressing multiple and. Multiple and concurrent sexual partnerships among youth and adults in swaziland people in concurrent partnerships. Multiple and concurrent partnerships, the big house, spare tire, and sugar daddythese are just a few of the terms used to refer to multiple sexual partners.
Indeed, aids has been identified as the leading cause of death ahead of. Tadiwa nyatangapfupa, communications officer for nac. Recently a woman told me i was sharing with a woman church lay leader one that i respect like my own mother in a rural congregation, that my husband and i were having some misunderstanding. I dont use a condom with my regular partner because i. Understanding the causes of sexual concurrency in a given geography and with a given group is an important step toward developing effective hiv prevention programming. Concurrent sexual partnerships and the spread of hiv the. Bulled 2015 argues that the primary risk factor for heterosexual partnerships is multiple concurrent partnerships mcp. Concurrent partnerships, acute infection and hiv epidemic dynamics among young adults in zimbabwe. Concurrent sexual partnerships play a key role in sustaining the hiv epidemic in. Queen consulting group hiring sql report developer in.
Multiple partnerships and nonmarital concurrency were reported much more frequently by men 34. The practice by men and women of having more than one sexual partner at the same time, otherwise known as multiple concurrent sexual partners mcp, is a disturbing factor in our societies. A sexual network is a group of people who are connected to one another through direct or indirect sexual contact. Concurrent sexual partnerships and the spread of hiv. Some hiv experts think the main reason for the decline in zimbabwe is the economic collapse, first author daniel halperin, phd, lecturer on global health at. The story of zimbabwe are small houses a key driver.
Since its initial detection in 1986, hivaids has spread at alarming rates in lesotho. By using this site, you agree that we may store and access cookies on your device. Tackling hivaids through social and behavior change. Dec, 20 concurrent partnerships are powerful transmitters of hiv in the community. Concurrent sexual partnerships among married zimbabweans ncbi. Using demographic and health surveys, the analysis shows that migrant miners ages 3044 are 15 percentage points more likely to be hiv positive, and women whose partner is a migrant miner are 8. Multiple and concurrent sexual partnerships in southern africa. Students in institutions of higher education in zimbabwe. Ability to organize, plan, and carry out multiple concurrent objectives or activities, an effectively make judgments in prioritizing and time allocation ability to work independently as well as. Therefore, the more men and women in a society have more than one partner, the more people in the network become linked to each other. Concurrent partnerships are powerful transmitters of hiv in the community. Jan 01, 2014 multiple episodes of unprotected vaginal intercourse with 2 of their most recent partners was reported by 60% of women who had both concurrent partnerships and nonmonogamous partners, 50% with only concurrent partners and no partners concurrency, and 33% with only partners concurrency versus 14% of women with neither type of concurrency. Psi collects cookies on this website to ensure you have the best experience.
Each individual is linked to his or her own sexual partners, to their partners sexual partners, to those peoples sexual partners, and so on. Partner reduction and fidelity appear to be the main behavioral changes accountable for the decrease in kenyas hiv infection rates. Multiple and concurrent sexual partnerships among youth and adults in swaziland alcohol emerged as a major contributing factor to multiple sexual partners. For example, it has been argued that the migrant labour system, imposed under colonial and apartheid rule, transformed south africa into an. Regarding sociodemographic factors associated with concurrency, females.
Earlier simulation models show that the network effect of concurrency can increase hiv incidence, but those models do not account for the coital dilution effect nonprimary partnerships have lower coital frequency than primary partnerships. A recruitment profile identified people involved in mcp. Married couples are at an increased risk of contracting hiv from sexual networks produced by concurrent sexual partnerships. Earlier simulation models show that the network effect of concurrency can increase hiv incidence, but those models do not account for the coital dilution effect nonprimary partnerships have lower coital frequency than.
In 2000, king letsie iii declared hivaids a natural disaster. Ldhs data from 2009 indicates that bonyatsi practices, the culturally sanctioned practice of maintaining many sexual partners, continues after marriage, as 9% of women and 24. Mcp is the practice of having multiple longterm sexual partners that overlap in time, often for months or years. Dec 01, 2011 launched on south african television in june 2008, the scrutinize campaign was a yearlong series of hiv prevention ads targeting multiple and concurrent sexual partnerships. Zimbabwe government and orc macro, 2007, where the mining industry is. Many species are infected by lentiviruses, which are characteristically responsible for longduration illnesses with a long incubation period.
Sadc in may 2006 pointed to high of multiple and concurrent sexual partnerships by men and women, with insufficient consistent, correct condom use, and combined with low levels of male circumcision, as the key drivers of the hiv epidemic in the region. This study, by determining socioeconomic correlates of multiple sexual partnerships among formerly married men in zimbabwe, will contribute to the ongoing debate about understanding factors that are. Namibia, south africa, swaziland, tanzania, zambia, and zimbabwe. Zimbabwe is one of unaids priority countries for the scale up of voluntary medical male circumcision vmmc, and vmmc being listed in the countrys current prevention strategy zimbabwe. Dissatisfaction in relationships many participants talked about being sexually dissatisfied with their steady or love partners. On world aids day dec 1, two decades after the discovery of the virus that causes aids and after many millions of deaths, we believe it is critical to reach consensus on a sound publichealth approach to the. Our qualitative study presents the socioeconomic factors that contribute to. These concurrent partnerships enable hiv to spread quickly within sexual networks. The o icheke multiple concurrent partnership campaign was positively viewed as playing a key role in addressing the apparent knowledge gap regarding the impacts of these partnerships and in changing peoples attitudes towards mcp. The theory that multiple, overlapping sexual partnerships are a key driver of generalised hiv epidemics in africa has been attacked as being based on insubstantial evidence.
Irreverent and humorous, with strong, colorful visuals, the campaigns ads were markedly different from previous south african hiv prevention campaigns for youth. It is clear, however, that multiple sexual partners, whether serial or concurrent. Mobile workers, such as truck drivers, were identified as the group most involved in. Zimbabwe is a landlocked sovereign state located in southern africa. Even if multiple concurrent partnerships turn out to represent a potentially greater risk for hiv infection during the acute stage, programmes that have as their goal the simple reduction in the number of mcp are losing sight of the real goal of hiv prevention. Concurrent sexual partnerships play a key role in sustaining the hiv epidemic in zimbabwe. Partner reduction and fidelity appear to be the main behavioral changes accountable for the decrease in. Our experts trained a local organization in lesotho to help couples and communities discuss multiple concurrent sexual partnerships, which increase the risk of spreading hiv. Multiple and concurrent sexual partnerships in swaziland.
Given the significant role of multiple sexual partners in sustaining the hiv epidemic, reducing sexual hiv transmission is an international hiv prevention priority. Hivaids centre for infectious disease research in zambia. Multiple concurrent partnerships among men and women aged 15. According to current estimates from the joint united nations programme on hivaids unaids, adult hiv prevalence is 12. Hivaids in lesotho constitutes a very serious threat to the basotho people and lesothos economic development. Zimbabwe has successfully managed to reduce the estimated prevalence of hiv among adults aged 1549 years from 29. Even though there are many ways to refer to such partnerships, the risk is the same. Concurrent sexual partnerships and the hiv epidemic in subsaharan africa. Basically, large sexual networks where everyone has sex with everyone, eventually, and no consistent safe sex is had. Concurrent sexual partnerships and primary hiv infection.
The practice of multiple sexual partnerships has been shown to be the most important risk factor in the transmission of hiv, 19 but the characteristics of each sexual partnership e. S everal decades into the aids pandemic, hiv transmission in most of the world remains firmly concentrated among sex workers, men who have sex with men msm, injecting drug users idus, and their sex partners 11. Similar results were found in a study in zimbabwe by kesby. There are various reasons why men and women participate in multiple concurrent. The time has come for common ground on preventing sexual. The concurrency hypothesis asserts that high prevalence of overlapping sexual partnerships explains extraordinarily high hiv levels in subsaharan africa. The prevalence of concurrent sexual partnerships among students. Local perceptions of the forms, timing and causes of behavior change in response to the aids epidemic in zimbabwe.
Why are multiple, concurrent sexual partnerships very bad and why does it spread hiv very fast. Multiple and concurrent sexual partnerships in southern africa reasons for multiple concurrent partnerships participants reported a range of reasons for their involvement in mcp. Concurrent sexual partnerships and associated factors. It is roughly spherical with a diameter of about 120 nm, around 60 times smaller than a red blood cell. Concurrency is different from having multiple partners over a long. Multiple concurrent partnerships provide a compelling, if partial, resolution of the apparent paradox of africas high hiv infection rates. Addressing these partnerships is an international hiv prevention priority. Associated risk factors of stis and multiple sexual. Close to 600,000 people infected with hiv and aids are in need of treatment right now and yet less than 10% are accessing the life prolonging drugs. People often have sexual encounters because they are drunk and their judgement is impaired. Mineral exports, gold, 1 agriculture, and tourism are the main foreign currency earners of zimbabwe. Created through a collaborative effort by multiple organizations and projects. Paper by lois chingandu executive director of safaids introduction twentyfive years on, zimbabwes hiv and aids epidemic is characterised by a prevalence rate of 18.
Reducing multiple concurrent partnerships and implementing male circumcision on a large scale represent areas where future prevention efforts should focus. Launched on south african television in june 2008, the scrutinize campaign was a yearlong series of hiv prevention ads targeting multiple and concurrent sexual partnerships. In a follow up study in zimbabwe, multiple sexual partnerships msp prevalence of 40% for males and 6% females was reported and a recent study of community norms and attitudes towards multiple and concurrent sexual partnership reported a prevalence of 37. Dec 22, 2009 the theory that multiple, overlapping sexual partnerships are a key driver of generalised hiv epidemics in africa has been attacked as being based on insubstantial evidence. Ninety percent of new hiv infections in zambia are driven by structural and biomedical factors such as multiple and concurrent sexual partnerships, mother to child transmission, low and inconsistent condom use, low levels. Multiple concurrent partnerships defining the problem. Determinants of concurrent sexual partnerships within stable. Zvoushe hardlife university of zimbabwe department of political and administrative studies, p.
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