Understanding concurrent sexual partnerships among US men: examining relationship characteristics and racial differences

Racial and ethnic minorities continue to be disproportionately affected by sexually transmitted infections (STIs), including Human Immunodeficiency Virus (HIV), in the United States. Concurrent sexual partnerships, those that overlap in time, have been associated with increased STI prevalence and increase the spread of infection through a network. Different patterns of concurrent partnerships may be associated with varying STI risk depending on the partnership type (primary vs. non-primary) and the likelihood of condom use with each concurrent partner. One pattern potentially associated with high STI risk involves concurrency in the context of a co-parenting relationship, one in which a man and woman are the joint biological parents of a child. We examined the relationship between co-parenting and concurrency using data from 4,928 male respondents age 15-44 in the National Survey of Family Growth Cycle 6. Among men engaging in concurrency in the past 12 months, 18% included a co-parent as at least one of the concurrent sex partners. One third of black men involved in co-parenting concurrency were <25 years, compared to 23% of Hispanics and 6% of whites. Young black men (age 15-24) were more likely to engage in co-parenting concurrency than white men, adjusting for socio-demographic characteristics, sexual and other high-risk behaviors, and relationship quality. The largest racial differences in co-parenting concurrency prevalence were observed among men age 15-24. In the second aim, concurrent partnerships were further classified based on pattern of overlap. Compared to men engaging in non-co-parenting concurrency, men engaging in co-parenting concurrency were more likely to report inconsistent condom use during the last month and less likely to have used a condom with either concurrent partner at last sexual intercourse in bivariable analyses. In multivariable analyses, concurrency duration was longer for men engaging in co-parenting concurrency than for men engaging in non-co-parenting concurrency, but there were no differences in STI preventive/protective behaviors. These findings show that co-parenting concurrency is more common among young black and Hispanic men and suggest that concurrency involving co-parents could be associated with a high risk of STI transmission. A comprehensive understanding of the types of concurrent sexual partnerships and the contexts in which they occur is necessary

Concurrent Partnerships, Nonmonogamous Partners, and Substance Use Among Women in the United States

Objectives. We determined the prevalence, distribution, and correlates of US women's involvement in concurrent sexual partnerships, a sexual-network pattern that speeds population-wide HIV dissemination. Methods. We used sexual partnership dates reported by 7643 women in the 2002 National Survey of Family Growth to determine prevalence of concurrent sexual partnerships during the preceding 12 months. We examined associations between concurrency and sociodemographic characteristics and risk behaviors. Results. Prevalence of concurrent partnerships was 5.7% based on reported partnerships and 8.3% after adjustment for possible underreporting. Concurrency was associated with younger age (22 to 24 years: prevalence odds ratio [POR]=2.44) versus older age (40 to 44 years); marital status (formerly married: POR=6.56; never married: POR=3.81; vs married); Black race/ethnicity (POR=1.78); younger age at first sexual intercourse (12 to 13 years: POR=2.89) versus 18 years or older); having a nonmonogamous sexual partner (POR=6.96); having intercourse while ‘‘high’’ on drugs or alcohol (POR=1.61); binge drinking (POR=1.70); and crack or cocaine use (POR=2.72). Conclusions. The association of concurrency with nonmonogamous sexual partners and substance use suggests the existence of extensive sexual networks that link people at higher risk for HIV infection with increased opportunities for disseminating infection

Bed net ownership, use, and perceptions among women seeking antenatal care in Kinshasa, Democratic Republic of the Congo (DRC): opportunities for improved maternal and child health

Abstract: Background: To describe malaria knowledge, attitudes toward malaria and bed net use, levels of ownership and use of bed nets, and factors associated with ownership and use among pregnant women attending their first antenatal care (ANC) visit in Kinshasa, DRC. Methods: Women attending their first ANC visit at one maternity in Kinshasa were recruited to take part in a study where they were given free insecticide treated bed nets (ITNs) and then followed up at delivery and 6 months post delivery to assess ITN use. This study describes the baseline levels of bed net ownership and use, attitudes towards net use and factors associated with net use Results: Among 351 women interviewed at baseline, 115 (33%) already owned a bed net and 86 (25%) reported to have slept under the net the previous night. Cost was reported as the reason for not owning a net by 48% of the 236 women who did not own one. In multivariable analyses, women who had secondary school or higher education were 3.4 times more likely to own a net (95% CI 1.6–7.3) and 2.8 times more likely to have used a net (95% CI 1.3–6.0) compared to women with less education Conclusion: Distribution of ITNs in antenatal clinics in this setting is needed and feasible. The potential for ITN use by this target population is high

Sex ratio, poverty, and concurrent partnerships among men and women in the United States: a multilevel analysis

Social and economic contextual factors may promote concurrent sexual partnerships, which can accelerate population HIV/STI transmission and are more common among African Americans than U.S. Whites. We investigated the relationship between contextual factors and concurrency

Incarceration and High-Risk Sex Partnerships among Men in the United States

Incarceration is associated with multiple and concurrent partnerships, which are determinants of sexually transmitted infections (STI), including HIV. The associations between incarceration and high-risk sex partnerships may exist, in part, because incarceration disrupts stable sex partnerships, some of which are protective against high-risk sex partnerships. When investigating STI/HIV risk among those with incarceration histories, it is important to consider the potential role of drug use as a factor contributing to sexual risk behavior. First, incarceration’s influence on sexual risk taking may be further heightened by drug-related effects on sexual behavior. Second, drug users may have fewer economic and social resources to manage the disruption of incarceration than nonusers of drugs, leaving this group particularly vulnerable to the disruptive effects of incarceration on sexual risk behavior. Using the 2002 National Survey of Family Growth, we conducted multivariable analyses to estimate associations between incarceration in the past 12 months and engagement in multiple partnerships, concurrent partnerships, and unprotected sex in the past 12 months, stratified by status of illicit drug use (defined as use of cocaine, crack, or injection drugs in the past 12 months), among adult men in the US. Illicit drug users were much more likely than nonusers of illicit drugs to have had concurrent partnerships (16% and 6%), multiple partnerships (45% and 18%), and unprotected sex (32% and 19%). Analyses adjusting for age, race, educational attainment, poverty status, marital status, cohabitation status, and age at first sex indicated that incarceration was associated with concurrent partnerships among nonusers of illicit drugs (adjusted prevalence ratio (aPR) 1.55, 95% confidence interval (CI) 1.06–2.22) and illicit drug users (aPR 2.14, 95% CI 1.07–4.29). While incarceration was also associated with multiple partnerships and unprotected sex among nonusers of illicit drugs (multiple partnerships: aPR 1.66, 95% CI 1.43–1.93; unprotected sex: aPR 1.99, 95% CI 1.45–2.72), incarceration was not associated with these behaviors among illicit drug users (multiple partnerships: aPR 1.03, 95% CI 0.79–1.35; unprotected sex: aPR 0.73, 95% CI 0.41–1.31); among illicit drug users, multiple partnerships and unprotected sex were common irrespective of incarceration history. These findings support the need for correctional facility- and community-based STI/HIV prevention efforts including STI/HIV education, testing, and care for current and former prisoners with and without drug use histories. Men with both illicit drug use and incarceration histories may experience particular vulnerability to STI/HIV, as a result of having disproportionate levels of concurrent partnerships and high levels of unprotected sex. We hypothesize that incarceration works in tandem with drug use and other adverse social and economic factors to increase sexual risk behavior. To establish whether incarceration is causally associated with high-risk sex partnerships and acquisition of STI/HIV, a longitudinal study that accurately measures incarceration, STI/HIV, and illicit drug use should be conducted to disentangle the specific effects of each variable of interest on risk behavior and STI/HIV acquisition

Coparenting and Sexual Partner Concurrency Among White, Black, and Hispanic Men in the United States

Concurrent sexual partnerships (partnerships that overlap in time) increase the spread of infection through a network. Different patterns of concurrent partnerships may be associated with varying STI risk depending on the partnership type (primary vs. non-primary) and the likelihood of condom use with each concurrent partner. We sought to evaluate co-parenting concurrency, overlapping partnerships in which at least one concurrent partner is a co-parent with the respondent, which may promote the spread of sexually transmitted infections (STIs)

Terms Used for People Living With HIV in the Democratic Republic of the Congo

For this study we conducted in-depth interviews with 29 youth living with HIV (YLWH) and key informant interviews with 8 HIV care/support providers. We describe terms used to portray people living with HIV (PLWH) in Kinshasa, Democratic Republic of the Congo. Labels commonly used, mostly derogatory, described PLWH as walking corpses, dangers to others, or people deserving to die before others get infected. Blame and other accusations were directed at PLWH through anchoring or objectification. Being labeled sometimes made these youth suffer in silence, afraid to disclose their status, or avoid performing actions in public, preferring to let others do them. YLWH need psychosocial support to mitigate the harmful effects of these labels and strengthen their coping skills, whereas community, institutional, and national efforts are needed for stigma reduction

Bed net ownership, use and perceptions among women seeking antenatal care in Kinshasa, Democratic Republic of the Congo (DRC): Opportunities for improved maternal and child health

Abstract: Background: To describe malaria knowledge, attitudes toward malaria and bed net use, levels of ownership and use of bed nets, and factors associated with ownership and use among pregnant women attending their first antenatal care (ANC) visit in Kinshasa, DRC. Methods: Women attending their first ANC visit at one maternity in Kinshasa were recruited to take part in a study where they were given free insecticide treated bed nets (ITNs) and then followed up at delivery and 6 months post delivery to assess ITN use. This study describes the baseline levels of bed net ownership and use, attitudes towards net use and factors associated with net use Results: Among 351 women interviewed at baseline, 115 (33%) already owned a bed net and 86 (25%) reported to have slept under the net the previous night. Cost was reported as the reason for not owning a net by 48% of the 236 women who did not own one. In multivariable analyses, women who had secondary school or higher education were 3.4 times more likely to own a net (95% CI 1.6–7.3) and 2.8 times more likely to have used a net (95% CI 1.3–6.0) compared to women with less education Conclusion: Distribution of ITNs in antenatal clinics in this setting is needed and feasible. The potential for ITN use by this target population is high

Rethinking LGBTQIA students and collegiate contexts: Identity, policies, and campus climate

Rethinking LGBTQIA Students and Collegiate Contexts situates and problematizes identity interaction, campus life, student experiences, and the effectiveness of services, programs, and policies affecting LGBTQIA college students at both two- and four-year institutions. This volume draws from intersectional and critical perspectives to explore the complex ways in which LGBTQIA identities are shaped, discussed, and researched in higher education spaces. Chapters provide student affairs and higher education scholars with theory and practice perspectives on sociopolitical and historical contexts, student learning and development, support services, and explore how higher education reflects society\u27s pervasive stereotypes and lack of awareness of LGBTQIA students\u27 identity development and needs