Determinants of multiple sexual partnerships in South Africa.

BACKGROUND This paper aims to examine determinants of multiple sexual partnerships (MSPs) among South African men and women using a nationally representative sample. METHODS Quantitative and qualitative data from a 2008 population-based cross-sectional survey were used. The analysis focused on the 6990 (33.6% of total sample) who were 15 years and older and reported sexual activity in the prior 12 months. The qualitative component consisted of 15 focus group interviews investigating values underlying MSP behaviors. RESULTS Predictors of MSP common across gender were race, having a history of STI, being in a short relationships (<1 year) and suspecting the current partner of infidelity. MSP among men enjoyed greater community acceptance and was mainly done for social status. Furthermore, men reporting MSP were mostly younger (15-24 years old) and use condom at last sex. Among women, determinants of MSP included economic vulnerability, younger age at sexual debut and living in formal urban rather than formal rural areas. CONCLUSIONS The data presented in this paper reinforces the importance of MSP as a risk factor for HIV and outline factors that should strongly be considered in strengthening condom use promotion and of partner reduction programs messaging in South Africa.