archives@tulane.edu / Concurrency is defined as overlapping sexual partnerships where sexual intercourse with one partner occurs between two acts of intercourse with another partner. The behavior is frequently reported in the literature and can be considered normative within certain groups around the world. Despite this, there are many unanswered questions on the topic, which can impact HIV prevention and control service-delivery programs.
Three studies were conducted among a group of newly HIV-diagnosed persons identified by the New York City Department of Health and Mental Hygiene. First, bivariate analyses were conducted in order to address the differences between those who named their sexual partners and those who did not as well as those who reported sexual partner concurrency and those who did not among those who named their sexual partners. Tests of trend over the ten-year time period were conducted in order to assess trends in both the elicitation of sexual partners, self-report of anonymous sexual partners, and sexual partner concurrency. In the next study, bivariate analyses were conducted in order to identify differences in sexual risk behaviors between those reported sexual partner concurrency and those who did not. Both crude and adjusted logistic regression analyses were conducted in order to determine which sexual risk behaviors were predictors of sexual partner concurrency. In the final study, an additional set of bivariate analyses were conducted to determine differences in substance use behaviors between those who reported sexual partner concurrency and those who did not. Crude and adjusted logistic regression analyses were conducted in order to determine which substance use behaviors were predictors of sexual partner concurrency.
Of the 16345 newly HIV-diagnosed persons eligible for a partner services interview, the majority (83%) were interviewed. Of these 13697 patients, just over half named their sexual partners (N=6943). Of these, approximately 15% self-reported engagement in sexual partner concurrency. The first study indicated that several demographic differences existed between those who named their sexual partners and those who did not, as well as those who reported sexual partner concurrency and those who did not. In addition, trends indicate that the elicitation of sexual partners is decreasing over time, as is the trend in those reporting sexual partner concurrency. However, there is no linear trend in the self-report of anonymous sexual partners. The second study showed significant differences between those who reported sexual partner concurrency and those who did not with regard to HIV sexual-risk behavior. Further, several of these behaviors acted as predictors of sexual partner concurrency in both the crude and adjusted models. The third study also showed that there were several significant differences between those who reported sexual partner concurrency with regard to substance use behavior. Several of these behaviors acted as predictors of sexual partner concurrency in both the crude and adjusted models. However, contrary to the hypothesis, more stigmatized drug use (drug use other than or addition to marijuana and injection drug use) did not result in a stronger relationship with sexual partner concurrency compared to less stigmatized drug use.
Concurrent partnerships and accompanying relationship dynamics have implications for HIV programs including prevention, treatment, partner tracing, and notification. The results from this dissertation can be used to improve our understanding of relationship dynamics. This can be used to improve upon HIV service delivery programs, both future and those already in existence. / 1 / Nicole Burton
| Identifer | oai:union.ndltd.org:TULANE/oai:http://digitallibrary.tulane.edu/:tulane_119681 |
| Date | January 2020 |
| Contributors | Burton, Nicole (author), (author), Hassig, Susan (Thesis advisor), Harville, Emily (Thesis advisor), Misra, Kavita (Thesis advisor), School of Public Health & Tropical Medicine Epidemiology (Degree granting institution) |
| Publisher | Tulane University |
| Source Sets | Tulane University |
| Language | English |
| Detected Language | English |
| Type | Text |
| Format | electronic, pages: 98 |
| Rights | No embargo, Copyright is in accordance with U.S. Copyright law. |
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