Concurrent Sexual Partnerships and HIV/AIDS Among Youths in the Cape Metropolitan Area

This 43-page working paper, published by the Centre for Social Science Research, examines the frequency and correlates of concurrency in a representative multi-racial young adult (aged 16-26) population in the Cape Metropolitan Area in South Africa, using multivariate logistic regression.

According to the study, approximately 13% of sexually active young adults reported concurrency, though there was significant variability by sex and race, ranging from 33% of young black men to 2% of young coloured women reporting concurrency. Concurrency was associated with other high risk behaviours, including a higher number of lifetime sex partners and a lower age of sexual debut. The study also found that individuals who were married, had a personal income, or belonged to a religious denomination, were all less likely to report concurrency. In addition, individuals who had their sexual debut after age 14, who had had sexual debut less than two years ago, or had 1-3 lifetime sexual partners were significantly less likely to report concurrency.

Another strong finding reported in the study is that individuals who know that their partner has another partner are much more likely to have other partners themselves. The authors suggest that the association between knowledge about a partner's concurrency and engaging in concurrency could result in a "social snowball effect", whereby having a large proportion of individuals with concurrent partners within a community could perpetuate more individuals to have concurrent partners. However, they note that this snowball effect could have important prevention implications when working in reverse, in that if prevention interventions are able to slightly decrease the frequency of concurrent partnerships at first, the effect could subsequently be magnified. However, they recognise that achieving such a population-level snowball effect would likely require changes in social and cultural norms, which may be difficult.

The study recommends that comprehensive sexual education needs to reach young people before the onset of sexual experience, which for some may occur even before their teenage years. The ability of young people to appropriately utilise such a comprehensive education will be mediated not only by social and cultural factors, but also by their life skills, such as decision-making, negotiation, and relationship skills. The report recommends that relationship-building skills should include renewed emphasis on sexual exclusivity and the negative health and social consequences of concurrency.