Concurrent Heterosexual Partnerships, HIV Risk, and Related Determinants among the General Population in Zimbabwe

This 58-page study, published by PSI (Population Services International) Zimbabwe, documents types of concurrent relationships and explores factors and contexts influencing the practice of engaging in such relationships among the general population. This two-phase study is a follow-up to a 2006 qualitative survey that sought to understand moderating demographic characteristics of concurrent sexual practices. The report suggests that, while in the past HIV prevention initiatives have focused on reducing the number of sexual partners, emerging findings point to the importance of acknowledging overlapping sexual networks or concurrent relationships. Most couples in these relationships eventually stop using condoms, thus increasing vulnerability to the entire sexual network.

The paper provides data analysis and interpretation from phase one of the studies which assessed: how concurrent partnerships are defined and terminologies used by the general population for different types of male-female sexual relationships; different patterns of concurrent heterosexual partnerships and contexts for these relationships; and frequency of condom use and associated HIV risk within different concurrent relationships.

According to the author, results from this study can be used to develop communication campaigns to promote the reduction of concurrent relationships as well as safer sexual practices within these relationships. The report provides key areas for interventions and communications campaigns to address regarding condom use and the risks associated with unprotected sex. These include:

• the practice of not using condoms within a short time after a relationship begins;
• perceptions that young women and men (especially adolescents) are inexperienced sexually and thus low-risk;
• the lack of condom use among men who keep "small-houses";
• perceptions that divorced or separated women are low-risk, and the subsequent lack of condom use;
• the need for money, other goods, and/or services that overrides people's - particularly women's - fears, and perceived vulnerability for contracting HIV; and
• the fact that young men and women do not usually make the decisions regarding condom use, but acquiesce to the "authority" of the more dominant, older sexual partner.

The document also provides key recommendations for interventions that tackle the actual issue of concurrency, rather than just condom use for those practising concurrency:

• Stimulate more open communications between partners regarding sexual preferences and the need for and possibility of enjoying a stimulating sex life together.
• Men (and some women) perceive that they need to have sex on a frequent basis and thus seek other sexual opportunities when away from their regular partner. Suggesting alternative forms of recreation or safe ways to vent sexual frustration may represent one element of a communication campaign.
• A variety of economic and employment factors influence the practice of concurrency. The media and peers add to pressure that result in young women and men exchanging sex to older partners in return for non-essential items such as cell phones or fashion accessories to enhance their status.
• Corrupt practices and abuse of power practised by some people in authority, including teachers, policemen, magistrates and pastors, whereby sex is requested in exchange for favours such as good exam grades are exposing girls and women to risks for contracting HIV/AIDS.

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