Partnership Concurrency and HIV Incidence in a Population-Based Cohort Study in Rural Uganda

Elizabeth A. Sully, Princeton University
Kenneth Ekoru, MRC/UVRI Uganda Research Unit on AIDS
Janet Seeley, MRC/UVRI Uganda Research Unit on AIDS

Concurrent partnerships are viewed as a primary driver of the HIV epidemic in Sub-Saharan Africa. Current attempts to empirically test the concurrency hypothesis have been unsuccessful due to the lack of data on linked partnerships and HIV incidence over time. In this paper we overcome both limitations by comparing HIV incidence among spouses of men who report extra-spousal relationships and those that do not. The data come from a rural community of approximately 20,000 inhabitants in south-western Uganda and span a 10-year period starting in 2000. We employ Kaplan-Meier estimates of cumulative incidence, and discrete-time hazard models to determine the risk of sero-conversion among women. In preliminary analyses, we are unable to detect an effect of the husband’s extra-spousal partnerships on the HIV incidence of their wives. These findings add to a growing body of literature casting doubt on the role of concurrency in the HIV epidemic.