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    Gender asymmetry in concurrent partnerships and HIV prevalence.

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    Authors
    Leung, Ka Yin
    Powers, Kimberly A
    Kretzschmar, Mirjam
    Type
    Article
    Language
    en
    
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    Title
    Gender asymmetry in concurrent partnerships and HIV prevalence.
    Published in
    Epidemics 2017; 19:53-60
    Publiekssamenvatting
    The structure of the sexual network of a population plays an essential role in the transmission of HIV. Concurrent partnerships, i.e. partnerships that overlap in time, are important in determining this network structure. Men and women may differ in their concurrent behavior, e.g. in the case of polygyny where women are monogamous while men may have concurrent partnerships. Polygyny has been shown empirically to be negatively associated with HIV prevalence, but the epidemiological impacts of other forms of gender-asymmetric concurrency have not been formally explored. Here we investigate how gender asymmetry in concurrency, including polygyny, can affect the disease dynamics. We use a model for a dynamic network where individuals may have concurrent partners. The maximum possible number of simultaneous partnerships can differ for men and women, e.g. in the case of polygyny. We control for mean partnership duration, mean lifetime number of partners, mean degree, and sexually active lifespan. We assess the effects of gender asymmetry in concurrency on two epidemic phase quantities (R0 and the contribution of the acute HIV stage to R0) and on the endemic HIV prevalence. We find that gender asymmetry in concurrent partnerships is associated with lower levels of all three epidemiological quantities, especially in the polygynous case. This effect on disease transmission can be attributed to changes in network structure, where increasing asymmetry leads to decreasing network connectivity.
    DOI
    10.1016/j.epidem.2017.01.003
    PMID
    28169133
    URI
    http://hdl.handle.net/10029/621880
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.epidem.2017.01.003
    Scopus Count
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