Elsevier

The Lancet

Volume 374, Issue 9687, 1–7 August 2009, Pages 367-369
The Lancet

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Why multiple sexual partners?

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  • The long-term determinants of female HIV infection in Africa: The slave trade, polygyny, and sexual behavior

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    Multiple concurrent partnerships can be explained on biological and economic grounds, but they are also rooted in culture and history. According to Shelton (2009), only a superficial analysis would attribute them to men's “uncontrollable sexual urges” on the one hand, and to the weak economic and cultural position of women in African societies, on the other. Instead, a prominent explanation is female dissatisfaction with primary relationships, due to lack of communication, sexual discontent, physical abuse, or economic issues.

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    Prevention programmes have focused on both most-at-risk populations9 and HIV-positive individuals.10 Many individuals in stable relationships are infected,11 which has led to growing interest in the role of concurrent relationships in fuelling the epidemic.12–14 Data from the first demographic and health surveys (DHS) to include results from HIV tests suggest that in at least two-thirds of couples in whom at least one of the partners is HIV positive, only one person is infected.15

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