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PLoS One. 2017 Aug 24;12(8):e0182567. doi: 10.1371/journal.pone.0182567. eCollection 2017.

Concurrency and other sexual partnership patterns reported in a survey of young people in rural Northern Tanzania.

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MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom.
Independent consultant, Dar es Salaam, Tanzania.
National Institute for Medical Research, Mwanza, Tanzania.
Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom.
World Health Organization, Geneva, Switzerland.


African adolescents and young adults remain at substantial risk of infection with HIV and other sexually transmitted infections (STIs), and AIDS is the leading cause of death among African adolescents (10-19 years). Sexual partnership patterns influence transmission risk of sexually transmitted infections. We describe patterns reported by youth (15-30y) in a community-based survey in Tanzania. Among participants reporting multiple partners, we investigated factors associated with reported concurrency. Female (N = 6513) and male (N = 7301) participants had median ages of 21 and 22 years, respectively. Most participants (92%) reported having previously been sexually active, of whom 15% of males and <1% of females reported ≥4 partners in the past year. The point prevalence of concurrency was 2.3% (95%CI 1.9-2.9) for females and 10.6% (95%CI 9.3-12.1) for males. High levels of multiple and concurrent partnerships were reported by those previously married. Females were more likely than males to report having spousal/regular partners and longer partnership lengths. Compared to males, the partnerships reported by females were less likely to be new partnerships, and more likely to be defined by the respondent as still 'ongoing'. Females reporting younger sexual debut were more likely to report concurrent sexual partners. Far fewer young women reported multiple and concurrent partnerships, but we cannot definitively conclude that concurrency was uncommon for women, because stigma towards women's multiple sexual partnerships might contribute to substantial under-reporting, as was found in extensive qualitative research in the study population. This study provides one of the most comprehensive quantitative descriptions of partnership patterns of young people in an African setting. Interventions addressing sexual risk among youth should involve male partners, empower women to protect themselves within different types of partnerships, and encourage a greater openness about young people's sexual relationships.

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