Population Council, Washington, DC, USA (Tun / Sheehy); Population Council, Johannesburg, South Africa (Sohaba)

This poster presentation, exhibited at the 2009 meeting of the International AIDS Society in Cape Town, South Africa, examines multiple concurrent partnerships (MCPs) in South Africa's Eastern Cape Province. Seeking to understand the gender and power dynamics that underpin these relationships, a survey was conducted among church-going women in the community. Questions examined the women's perceptions about a partner's infidelity, their ability to speak openly with their partners about this, and their exposure to forms of intimate partner violence. The research found that a high-proportion of women believed their partners were unfaithful and that several factors among women were significantly associated with partner's infidelity, experiencing gender-based violence, being unable to discuss infidelity openly as well as reporting low-levels of relationship control.

The presentation suggests that the practice of having multiple concurrent partnerships is culturally sanctioned in many parts of South Africa and is often inextricably linked to gender power differentials. Power imbalances in sexual relationships can hinder healthy couple communication and negotiation for safer sex, and may facilitate gender-based violence, which in turn can increase women's vulnerability to HIV. According to the study, approximately 20% of women surveyed indicated that they believed their partners were unfaithful. Of these women, almost 30% thought their partners were having sex with more than one other partner. Additionally, about 10% of women reported experiencing gender-based violence, with 12% reporting psychological abuse and slightly less reporting physical or sexual abuse.

Experiencing abuse as well as perceived difficulty in discussing infidelity with a partner were both significantly associated with an increased likelihood that a partner was reported as being unfaithful. The strongest factor associated with reported infidelity was a low level of relationship control, or that women described their partner as exerting overwhelming control over the relationship. For instance, more than a third of respondents indicated that they had low control over sex within a relationship.

The presentation mentions a church-based partner reduction intervention, designed for both men and women, to increase gender equity and improve couple communication and conflict resolution skills. The intervention uses church leaders to influence and facilitate congregation members to bring about positive behaviour change. It is currently being evaluated by the Population Council.

In a time where many HIV prevention programmes are beginning to recognise MCPs as a key driver of the HIV epidemic in southern Africa, the presentation concludes by recommending that programmes seeking to reduce the prevalence of MCPs in the country must also address issues of gender inequality and gender-based violence within relationships and should be designed for both men and women.

Population Council website on September 11 2009.