Gender differences in the risk of HIV infection among persons reporting abstinence, monogamy, and multiple sexual partners in northern Tanzania.

Landman, Keren Z

Ostermann, Jan

Crump, John A

Mgonja, Anna

Mayhood, Meghan K

Itemba, Dafrosa K

Tribble, Alison C

Ndosi, Evaline M

Chu, Helen Y

Shao, John F

Bartlett, John A

Thielman, Nathan M

Myer, Landon

United States

2011-06-21T17:31:25Z

2008-08-27

BACKGROUND: Monogamy, together with abstinence, partner reduction, and condom use, is widely advocated as a key behavioral strategy to prevent HIV infection in sub-Saharan Africa. We examined the association between the number of sexual partners and the risk of HIV seropositivity among men and women presenting for HIV voluntary counseling and testing (VCT) in northern Tanzania. METHODOLOGY/ PRINCIPAL FINDINGS: Clients presenting for HIV VCT at a community-based AIDS service organization in Moshi, Tanzania were surveyed between November 2003 and December 2007. Data on sociodemographic characteristics, reasons for testing, sexual behaviors, and symptoms were collected. Men and women were categorized by number of lifetime sexual partners, and rates of seropositivity were reported by category. Factors associated with HIV seropositivity among monogamous males and females were identified by a multivariate logistic regression model. Of 6,549 clients, 3,607 (55%) were female, and the median age was 30 years (IQR 24-40). 939 (25%) females and 293 (10%) males (p<0.0001) were HIV seropositive. Among 1,244 (34%) monogamous females and 423 (14%) monogamous males, the risk of HIV infection was 19% and 4%, respectively (p<0.0001). The risk increased monotonically with additional partners up to 45% (p<0.001) and 15% (p<0.001) for women and men, respectively with 5 or more partners. In multivariate analysis, HIV seropositivity among monogamous women was most strongly associated with age (p<0.0001), lower education (p<0.004), and reporting a partner with other partners (p = 0.015). Only age was a significant risk factor for monogamous men (p = 0.0004). INTERPRETATION: Among women presenting for VCT, the number of partners is strongly associated with rates of seropositivity; however, even women reporting lifetime monogamy have a high risk for HIV infection. Partner reduction should be coupled with efforts to place tools in the hands of sexually active women to reduce their risk of contracting HIV.

Version of Record

https://www.ncbi.nlm.nih.gov/pubmed/18728779

1932-6203

https://hdl.handle.net/10161/4504

eng

en_US

Public Library of Science (PLoS)

PLoS One

10.1371/journal.pone.0003075

Plos One

Adolescent

Adult

Female

HIV Infections

HIV Seropositivity

Humans

Male

Risk Factors

Sex Characteristics

Sexual Abstinence

Sexual Behavior

Tanzania

Gender differences in the risk of HIV infection among persons reporting abstinence, monogamy, and multiple sexual partners in northern Tanzania.

Journal article

Crump, John A|0000-0002-4529-102X

Thielman, Nathan M|0000-0001-8152-2879

2008-8-27

8

3

https://www.ncbi.nlm.nih.gov/pubmed/18728779

e3075

8

Clinical Science Departments

Duke

Duke Cancer Institute

Duke Science & Society

Faculty

Initiatives

Institutes and Centers

Institutes and Provost's Academic Units

Medicine

Medicine, Infectious Diseases

Nursing

Pathology

School of Medicine

School of Nursing

Published online

3