Social and Cultural Contexts of Concurrency in Khayelitsha

The continued high prevalence of HIV in the hyper-epidemics of southern Africa, has led to calls for renewed and re-thought prevention efforts (UNAIDS, 2008, Potts et al., 2008, Merson et al., 2008, Green et al., 2009). The topic of concurrent sexual partnerships has emerged as an important intervention point for HIV prevention in the generalized epidemics of southern Africa (SADC HIV/AIDS Unit - SADC Secretariat, 2006, Soul City Institute Regional Programme, 2008, Parker et al., 2007). Concurrent sexual partnership or partnerships that overlap in time may increase the risk of HIV acquisition (Morris and Kretzschmar, 1997, Mah and Halperin, 2008, Halperin and Epstein, 2004). In South Africa, several studies have reported that concurrent partnerships are common (Colvin et al., 1998, Parker et al., 2007, Mah, 2008b). In order to best understand how to reduce the prevalence of concurrency for HIV prevention, better knowledge about the social, cultural and economic contexts is needed. Decisions related to sexual partnerships are influenced by a multitude of factors, including those at the individual level and those within wider social and cultural contexts. This study aims to increase the understanding of these social, cultural, and economic aspects of concurrent sexual partnerships in South Africa. The design and analysis of this research were guided by four broad aims: 1) to obtain perceptions of the frequency of concurrent partnerships among participants; 2) to develop a better understanding of the rationale for the existence of and participation in concurrent partnerships; 3) to describe the knowledge and attitudes, if any, that link concurrency, HIV and the risk of HIV; and 4) to describe the feasibility of behavior change, including the types of interventions that might be effective in reducing the frequency of concurrency.