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A microsimulation study of the effect of concurrent partnerships on the spread of HIV in Uganda

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  • Martina Morris
  • Mirjam Kretzschmar

Abstract

This paper examines the potential impact of concurrent partnerships on HIV spread in Uganda using microsimulation. We represent a population of individuals, the sexual partnerships that they form and dissolve over time, and the spread of an infectious disease as a stochastic process. Data from the 1994 Ugandan sexual network survey are used to establish baseline outcomes, and the baseline is compared to sequential monogamy, increased concurrency and increased number of partnerships. The observed level of concurrency raises the number of infected cases by about 26% at the end of 5 years compared to sequential monogamy. Increasing both the number of partnerships and the rate of concurrency together has a stronger impact than increasing either alone. If risk behaviors were slightly higher at the start of the Ugandan epidemic, concurrency may have amplified the prevalence of HIV by a factor of 2 or 3. The public health implications are that data must be collected properly to measure the levels of concurrency in a population, and that messages promoting “one partner at a time”; are as important as messages promoting fewer partners.

Suggested Citation

  • Martina Morris & Mirjam Kretzschmar, 2000. "A microsimulation study of the effect of concurrent partnerships on the spread of HIV in Uganda," Mathematical Population Studies, Taylor & Francis Journals, vol. 8(2), pages 109-133.
    • Handle: RePEc:taf:mpopst:v:8:y:2000:i:2:p:109-133
    DOI: 10.1080/08898480009525478
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    Citations

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    Cited by:

    1. Raouf Boucekkine, 2012. "Epidemics From the Economic Theory Viewpoint," Mathematical Population Studies, Taylor & Francis Journals, vol. 19(1), pages 1-3, January.
    2. Alan G. Isaac & Larry Sawers, 2019. "Partnership duration and concurrent partnering: implications for models of HIV prevalence," Journal of Economic Interaction and Coordination, Springer;Society for Economic Science with Heterogeneous Interacting Agents, vol. 14(2), pages 293-315, June.
    3. Georges Reniers & Rania Tfaily, 2012. "Polygyny, Partnership Concurrency, and HIV Transmission in Sub-Saharan Africa," Demography, Springer;Population Association of America (PAA), vol. 49(3), pages 1075-1101, August.
    4. Brendan Maughan-Brown, 2011. "Concurrent sexual partnerships and sexually transmitted diseases among African men in Cape Town, South Africa," SALDRU Working Papers 70, Southern Africa Labour and Development Research Unit, University of Cape Town.
    5. Michelle Poulin & Adamson S. Muula, 2011. "An inquiry into the uneven distribution of women’s HIV infection in rural Malawi," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 25(28), pages 869-902.
    6. Eva Enns & Margaret Brandeau, 2011. "Inferring model parameters in network-based disease simulation," Health Care Management Science, Springer, vol. 14(2), pages 174-188, June.
    7. Leung, K.Y. & Kretzschmar, M.E.E. & Diekmann, O., 2012. "Dynamic concurrent partnership networks incorporating demography," Theoretical Population Biology, Elsevier, vol. 82(3), pages 229-239.
    8. repec:jss:jstsof:24:i07 is not listed on IDEAS
    9. Shelley Clark, 2010. "Extra-marital sexual partnerships and male friendships in rural Malawi," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 22(1), pages 1-28.
    10. Megan Klein Hattori, 2018. "Young Adults’ Understanding of Fidelity: Social Structure and Relationship-Level Barriers to Fidelity Described During In-depth Interviews in Dar es Salaam, Tanzania," Sociological Research Online, , vol. 23(3), pages 622-636, September.

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