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Polygyny and symmetric concurrency: comparing long-duration sexually transmitted infection prevalence using simulated sexual networks
  1. Shalini Santhakumaran1,2,
  2. Katie O'Brien1,
  3. Roel Bakker3,4,
  4. Toby Ealden1,
  5. Leigh Anne Shafer5,
  6. Rhian M Daniel1,
  7. Ruth Chapman1,
  8. Richard J Hayes1,
  9. Richard G White1
  1. 1London School of Hygiene and Tropical Medicine, London, UK
  2. 2Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
  3. 3Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
  4. 4Hogeschool Rotterdam, Rotterdam, The Netherlands
  5. 5Medical Research Council Programme on AIDS in Uganda, Uganda Virus Research Institute, Entebbe, Uganda
  1. Correspondence to Dr Richard G White, Infectious Disease Epidemiology Unit, Department of Epidemiology and Public Health, and Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK; richard.white{at}lshtm.ac.uk

Abstract

Objective To compare the effects of polygyny (only men can form concurrent partnerships) and gender-symmetric concurrency (both genders can form concurrent partnerships) on prevalence of long-duration sexually transmitted infections (STIs) using a dynamic stochastic network model.

Methods We modelled two pairs of scenarios: polygyny and gender symmetry at higher and lower levels of network concurrency (measured by the average number of concurrent partnerships per partnership). The same level of sexual activity was modelled in all scenarios (measured by mean per capita partnership incidence and per capita number of sex acts). Partnership duration and network concurrency were constant within each of the polygyny/symmetry pairs. Infections that mimicked characteristics of herpes simplex virus type 2 (HSV2) and HIV were introduced onto the networks separately. The mean prevalence 100 years after introduction for the HSV2-like infection and 30 years after introduction for the HIV-like infection were calculated over 1000 model iterations.

Results Prevalence of both simulated STIs was significantly lower in the polygyny scenarios than in the symmetry scenarios. At lower concurrency, polygyny resulted in a relative reduction in HSV2-like infection prevalence of 19% (95% CI 15 to 23) compared to gender symmetry. At higher concurrency polygyny led to a relative reduction of 20% (16 to 23). The relative reduction in prevalence of the HIV-like infection after 30 years was 14% (10 to 17) at lower concurrency and 8% (5 to 11) at higher concurrency.

Conclusions Polygyny can result in lower STI prevalence compared to populations where both genders practise concurrency. Further work is required to explore whether this reduction is observed when modelling more realistic populations and infection characteristics.

  • Mathematical model
  • HIV
  • HSV 2
  • sexual behaviour
  • concurrency
  • polygamy
  • mathematical model
  • sexual networks

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Footnotes

  • Funding This work was supported by the Wellcome Trust (RGW, RC and RJH (GR078499MA)), the UK Medical Research Council (RGW, KOB, RB, TE, RJH and LAS), the Bill and Melinda Gates Foundation (RGW), the EU FP7 EPIWORK (231807) (RGW) and GlaxoSmithKline (SS). The funders had no involvement in the design, collection, analysis or interpretation of the data, in writing the report or in the decision to submit.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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