Sexual partnership concurrency and age disparities associated with sexually transmitted infection and risk behavior in rural communities in Kenya and Uganda. (July 2022)

• Record Type: Journal Article
• Authors: Okiring, Jaffer; Getahun, Monica; Gutin, Sarah A.; Lebu, Sarah; Lee, Joi; Maeri, Irene; Eyul, Patrick; Bukusi, Elizabeth A.; Cohen, Craig R.; Neilands, Torsten B.; Ssali, Sarah; Charlebois, Edwin D.; Camlin, Carol S.
• Is Part Of: International journal of infectious diseases. Volume 120(2022)
• Page Start: 158
• Page End: 167
• Publication Date: 2022-07
• Subjects: Age disparity -- Sexual risk -- STIs -- Concurrency -- Population mobility -- Sub-Saharan Africa; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2022.04.038
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: Historically, young women in age-disparate relationships have elevated risk for HIV. Partner age and concurrency were associated with NG/CT in women, but not men. Sexual partnership concurrency was associated with higher-risk sex partners. Women in age-homogeneous relationships had higher odds of condom use. HIV prevention for couples in age-disparate and concurrent relationships is needed. ABSTRACT: Objectives: We examined sex-specific associations of partner age disparity and relationship concurrency with Neisseria gonorrhoeae and/or Chlamydia trachomatis (NG/CT) infection, higher-risk relationships, and condom use as proxies for HIV risk. Methods: Data were collected in 2016 from 2179 adults in 12 communities in Uganda and Kenya. Logistic regression models examined associations of age disparity and relationship concurrency with NG/CT infection, condom use, and higher-risk (commercial sex and other higher-risk) relationships in the past 6 months, controlling for covariates. Results: Partner age and relationship concurrency were associated with NG/CT infection in women but not men. Relative to women in age-disparate relationships, women in both age-disparate and age-homogeneous relationships had higher odds of NG/CT infection (adjusted odds ratio [aOR]=3.82, 95% confidence interval [CI]: 1.46–9.98). Among men and women, partnership concurrency was associated with higher-risk partnerships. In addition, relative to those with a single age-homogeneous partner, those with concurrent age-homogeneous partners had higher odds of condom use (men: aOR=2.85, 95% CI: 1.89–4.31; women: aOR=2.99, 95% CI: 1.52–5.89). Concurrent age-disparate partnerships were associated with condom use among men only (aOR=4.02, 95% CI: 2.54–6.37). Conclusion: Findings underscore the importance of targeted HIV prevention efforts for couples in age-disparate and concurrent relationships.