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Extraspousal Partnerships in a Community in Rural Uganda With High HIV Prevalence: A Cross-Sectional Population-Based Study Using Linked SPousal Data


Ivan Kasamba, MSc, Elizabeth Sully, BA, Helen A. Weiss, PhD, et al.

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Background: The role of concurrent sexual partnerships in the HIV
epidemic in sub-Saharan Africa is not well understood. Although most
infections in Africa occur among married individuals, transmission may
occur from both spousal and extraspousal partnerships. This article
explores extraspousal partnerships as a form of concurrency, examining
the association with HIV status, demographic characteristics, and
sexual behaviors in a population-based cohort in rural Uganda.
Methods: Prevalence of extraspousal partnerships was estimated
using cross-sectional data from 2008, and adjusted odds ratios
(aOR) were estimated for factors associated with the prevalence of
extraspousal partnerships using logistic regression. Among men who
were not in polygynous marriages, we used linked spousal data to
investigate the association between extraspousal partnerships and
wives’ serostatus.
Results: Extraspousal partnerships in the past year were reported by
17% of married men and 2% of married women. Among both men
and women, extraspousal partnerships were associated with not
knowing their partners’ HIV status (men: aOR = 1.74; 95% CI: 1.13
to 2.67; women: aOR = 1.76; 95% CI: 1.13 to 2.75), and extraspousal
partnerships were also associated with increased condom use for
men. There was no evidence that men reporting extraspousal
partnerships were at increased risk of HIV (aOR = 0.98; 95% CI: 0.48
to 2.01), or that a woman’s risk of HIV was associated with her
husband reporting extraspousal partnerships (aOR = 0.68; 95% CI:
0.29 to 1.57).
Conclusions: For both men and women, extraspousal partnerships
were associated with not knowing their partners’ HIV status. There
was no evidence of an association of extraspousal partnerships with
HIV serostatus in this cross-sectional analysis.




Women; Behavior


Created at 8/19/2011 1:10 PM by Davis, Gregory P
Last modified at 8/19/2011 1:10 PM by Davis, Gregory P