Essential Knowledge

Multiple and concurrent sexual partnerships (MCP) are widely held to be one of the primary drivers of the HIV epidemic, especially in sub-Saharan Africa. Thus, many researchers and policymakers feel that reducing MCP and increasing awareness of the risks associated with MCP should be a major focus of HIV prevention programs and communication campaigns. Understanding the varieties and patterns of sexual relationships is a necessary element in implementing effective prevention programs. In addition to understanding the socio-cultural factors of MCP, researchers also need to define standardized, reliable and feasible methods for measuring MCP. Scientists still need to refine the methods for measuring and comparing sexual norms, behaviors, and networks in diverse cultural contexts and risk settings. Good tools for measuring MCP will allow for understanding the prevalence of MCP and monitoring and evaluation of MCP reduction programs. Moreover, consistent and shared terminology is important when defining and measuring MCP:

Multiple sexual partnerships: having more than one sexual partner over a period of time. These can be either serial partners (one after the other), or concurrent partners (different sexual partners that overlap in time).

Concurrent sexual partnerships: overlapping sexual partnerships where sexual intercourse with one partner occurs between two acts of intercourse with another partner.

Multiple and concurrent partnerships may refer to an overlapping combination of one's main partner with another partner or can include intermittent or occasional sexual
contacts, as well as one-off sexual relationships (sex worker, casual encounter).

This section of the MCP Toolkit provides key resources on MCP as well as research findings on MCP. To go directly to one of the sections, click on one of the links below:

Key Resources on Multiple and Concurrent Partnerships

Research Findings on Measuring MCP

Research Findings on Socio-Cultural Factors of MCP

Research Findings on Communication Efforts to Address MCP

Key Resources on Multiple and Concurrent Sexual Partnerships (13 resources)

Collected here is essential reading on the practice of multiple and concurrent partnerships, its role in the spread of HIV, and strategies to reduce its occurrence.

Research Findings on Measuring MCP

Who's In Your Sexual Network?: Ways of Asking Face-To-Face Quantitative Questions on Multiple Concurrent Partnerships (MCP)

2010 | Population Services International (PSI) Botswana | 1 p

English

This poster presents a summary of a study conducted in Botswana to understand different methods for measuring MCP. The study examined three methods commonly used to measure MCP. The study found little consistancy between methods and concluded that gender as a significant determinant of concurrency varies depending on how a question about MCP is asked.

2009 | United States Agency for International Development [USAID]

English

This study uses self-reported data on sexual partnerships and biomarker data on HIV serostatus that have been collected in recent years from adult women and men (age 15-49) by nationally representative Demographic and Health Surveys (DHS) and AIDS Indicator Surveys (AIS). Using information on up to three of the respondents’ most recent sexual partners, the authors evaluated and compared the prevalence of concurrent sexual partnership across countries.

2009 | International Union for the Scientific Study of Population | 9 p

English

Concurrent sexual partnerships have been associated with the spread of HIV/AIDS. Previous research suffers from poor measurement and a lack of details on concurrency, including characteristics of concurrent partnerships and unsafe sexual behavior within them. We use unique life history calendar data, which include monthly information on the sexual histories of young people in urban Kenya, to develop a new measure of concurrency, defined as having sex with 2 or more partners in the same month or series of months.

2008 | PEPFAR Technical Consultation | 34 slides

English

At PEPFAR's 2008 Technical Consultation "Addressing Multiple and Concurrent Sexual Partnerships in Generalized HIV Epidemics" Sara Nelson reviews quantitative approaches to measuring sex partner concurrency, the strengths and limitations of each, and provides some guidelines for selecting the right measures.

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Research Findings on Socio-Cultural Factors of MCP

Gender and Concurrent Sexual Partnerships in Zambia. Preliminary Analysis Findings.

2011 | FHI | 2 p

English

This study was designed to produce strategic information on determinants of sexual behavior, focusing particularly on social, economic, and cultural factors that promote concurrent sexual partnerships(concurrency). Its goal was to inform national gender interventions to prevent HIV.

2010 | FHI | 3 p

English

This three-page brief presents the findings of a mixed methods study conducted by the International Organisation for Migration (IOM) and Family Health International (FHI) in Zambia to explore the social, economic, and cultural factors related to engagement in multiple concurrent sexual partnerships (MCP).

2009 | Joint United Nations Programme on HIV/AIDS | 79 p

English

A qualitative study was undertaken in five communities in Lesotho with the aim of better understanding the social, economic and cultural considerations that influence individuals' decisions related to multiple sexual partnerships and the perception of HIV risk in such relationships. The goal of the study was to produce strategic information on determinants of sexual behavior, focusing particularly on social, economic and cultural factors that promote multiple concurrent sexual partnerships, with the purpose to inform national gender interventions targeting prevention of HIV.

2009 | Academy of Educational Development (AED) | C-Change | 44 p

English

This report analyzes C-Change formative research designed to understand how culturally-embedded communication about HIV and AIDS and sexual behavior contributes to sustaining the practice of multiple concurrent partners (MCP) in Lesotho. The findings from this research, together with a review of existing research, can help to inform message development for a short-term C-Change communication campaign focusing on HIV prevention through the promotion of dialogue about MCP.

2008 | Phela Health and Development Communications | 52 p

English

This 53-page qualitative research study on Multiple Concurrent Partnerships (MCP) in Lesotho was commissioned by Phela, a health and development non-governmental organisation (NGO), to inform communication interventions as part of its 5-year HIV prevention initiative.

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Research Findings on Communication Efforts to Address MCP

Concurrent Sexual Partnerships Amongst Young Adults in South Africa: Challenges for HIV Prevention Communication

2007 | Centre for AIDS Development, Research and Evaluation [CADRE] | 50 p

English

This report explores both quantitative and qualitative data related to the 20-30 year age group with a focus on concurrent sexual relationships amongst heterosexual respondents.

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