One researcher in South Africa commented that multiple sexual partners may have arisen because of cultural and economic values that maintain agriculture productivity, for example, through wife inheritance.
In other cultures, having more than one wife or girlfriend signifies wealth. But the difference in most African countries, Malawi included, is that women also cheat!
A South African study found that men who believed in gender equality were more likely to be monogamous whereas women who believed in the same were more likely to have multiple partners.
Another study found the blame being placed on menâ€™s promiscuity and women seeking revenge on their partners. However, both men and women acknowledge economic security and advancement as strong reasons for multiple partners.
Economic security also affects the age-mix of relationships as young girls will tend to have partners older than them which puts them at more risk of being exposed to the virus. Studies in South Africa and Swaziland have shown that women who report partners 10 years old than them have a higher prevalence than those who had partners of the same age.
The focus, however, does not lie only with heterosexual concurrent relationships, but bisexual concurrency. A study conducted in Namibia and Botswana of 537 men found that 17 percent of the men had concurrent relationships with both men and women (bisexual concurrency). It was encouraging in this study to find that men in concurrent relationships with men and women had higher levels of condom use than men who exclusively slept with other men.
Knowing that concurrent long-term relationships are spreading HIV calls for reconsideration of the current HIV prevention messages. It needs to be clear that even when the number of multiple partners are low, the risk in the sexual network is still high. People have the false security that having one extra long-term concurrent partner is not risky, but this is a high-risk behaviour.
Concurrency is a theory and not all scientists agree. Those against the idea of concurrency fuelling the southern African epidemic argue that concurrency is based on mathematical models and not scientific (clinical) studies, these models have questionable assumptions like the frequency of sexual contact or do not take into consideration one-off encounters or casual sex.
The problem with concurrency hypothesis is that it is not a theory about a partnerâ€™s risk of acquiring HIV, but of their partnersâ€™ risk of transmitting it.