Botswana 2009 Botswana 2009  

Abstract #170  -  Who has multiple concurrent sexual partnerships in Botswana? Results of a national cross sectional survey
  Presenting Author:   Ms Ditiro Laetsang - CIET Trust
  Additional Authors:  Mr Ari Ho-Foster, Mr Mokgweetsi Masisi, Dr Marina Anderson, Dr Derrick Tlhoiwe, Dr Anne Cockcroft, Prof Neil Andersson,  
Botswana has a high prevalence of HIV and, like other countries in the region, faces challenges in reducing the rate of new infections. A key concern is to reduce the number of people with multiple concurrent sexual partnerships (MCP), that carry a high risk of HIV transmission. This study examines reported MCP and the factors associated with this in Botswana.
  Method / Issue:
We analysed data from interviews with people aged 16-60 years in a national stratified random cluster sample of communities across Botswana in 2007. We defined MCP as having more than one sexual partner in the last month, among people who had at least one. Bivariate and then multivariate analysis examined associations between individual and community factors and MCP. We examined age, sex, marital status, education, education relative to partners, income, income relative to partner, food sufficiency, urban or rural dwelling, experience of intimate partner violence, and choice disability (defined as those who would have sex if their partner refused to use a condom and believed their partner was at risk of HIV). We developed separate models for men and women, and report associations as the adjusted Odds Ratios and 95% confidence intervals, adjusted for clustering.
  Results / Comments:
There were 768 male and 1784 female respondents. Some 10% of those that had at least one partner during the last month reported multiple partners. Men reported MCP much more commonly than women (19% vs. 6%, chi-square 65.3). Among men, those with more than primary level education were more likely to report having MCP than those who were less educated (OR 2.13, 95% CI 1.19 - 3.85). Men who were neither married nor cohabiting were more likely to report having MCP (OR 2.29, 95% CI 1.28 - 4.11), as were those 17% of men who had experienced partner violence in the last year (OR 2.59, 95% CI 1.51 - 4.45). Some 15% of men were choice-disabled by our definition; they were much more likely to report MCP (OR 8.32, 95% CI 3.38 20.46). Among women, only one factor remained significantly associated with MCP: women who said they earned more or the same as their partner (30%) were more likely to report MCP (OR 1.69, 95% CI 1.19 2.41).
The higher rate of MCP among men agrees with previous studies and reflects the greater willingness of men to report MCP, as well as actual behaviour differences. The fewer cases of MCP among women may have made associations harder to detect. More educated men, with more access to resources, may feel they are expected to have more partners. The higher rate of MCP among men with choice-disability or who had experienced partner violence might reflect a greater tendency of such men to take risks. The finding among women may indicate a trend of women better off than their partners choosing to have more partners.
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