Partner Reduction
Gaps in Research
- 1.
- Evaluated interventions are urgently needed to reduce multiple and concurrent partnerships – particularly for both men and women where perceived HIV risk is low and the woman is subjected to gender norms of faithfulness while the man is subjected to gender norms of having multiple sexual partners.
- 2.
- Interventions are needed to reduce homophobia, which may lead MSM to have partnerships with women.
- 3.
- Innovation and research is needed on what works to reduce alcohol consumption and associated risks.
1. Evaluated interventions are urgently needed to reduce multiple and concurrent partnerships – particularly for both men and women where perceived HIV risk is low and the woman is subjected to gender norms of faithfulness while the man is subjected to gender norms of having multiple sexual partners. [See also Transforming Gender Norms] Studies found that married women were at risk of HIV acquisition, but were either unaware of the risk or did not believe they were at risk. Studies found that extra-relational sex on the part of the husband was common. Other studies found that a significant portion of women have had high rates of multiple partners. Other studies found that serial monogamous relationships led to a high risk of HIV acquisition.
Gap noted, for example, in Uganda (Wawer et al., 2012; Kajubi et al., 2011); India (Solomon et al., 2010a; Chatterjee and Hosain, 2006); China (Li et al., 2011a; Yun et al., 2011); South Africa and Zimbabwe (Mavedzenge et al., 2011a); South Africa (Mah, 2010); Nigeria (Adebayo et al., 2011; Oyediran et al., 2010); Botswana (Thomas and Lungu, 2010; Foster et al., 2010a); South Africa (Tanser et al., 2011); Mozambique (Noden et al., 2009); Tanzania (Exavery et al., 2011); Ethiopia (Molla et al., 2008); Zimbabwe (Callegari et al., 2008; Feldman and Maposhere, 2003); Mexico (Hirsch et al., 2007; Pulerwitz et al., 2001); Kenya and Zambia (Glynn et al., 2001; Glynn et al., 2003); Kenya (Kaiser et al., 2011); Zambia (Clark, 2004) and globally (Green et al., 2009) and from HPTN 052 sites (Eshleman et al., 2011).
2. Interventions are needed to reduce homophobia, which may lead MSM to have partnerships with women. Studies found that homosexuality was heavily stigmatized and that gender norms pressured MSM to marry and have families.
Gap noted, for example, in Nigeria (Etiebet et al., 2012a); Malawi, Namibia and Botswana (Beyrer et al., 2010b); China (Zhao, 2006): India (Gutierrez et al., 2010; Hernandez et al., 2006); and Nicaragua (Beyrer et al., 2010 cited in WHO et al., 2011b).
3. Innovation and research is needed on what works to reduce alcohol consumption and associated risks. A study of community interventions to reduce alcohol use found reduced sexual risk behavior. Wives perceive alcohol as a stimulus for men’s extramarital sex and violent behavior.
Gap noted, for example, in India (Schensul et al., 2010).