The Role of Relationship Types on Condom Use among High-Risk Urban Men with Concurrent Partners in Ghana and Tanzania

Paul J. Fleming, University of North Carolina at Chapel Hill
Marta Mulawa, University of North Carolina at Chapel Hill
Holly McClain Burke, FHI 360
Dominick Shattuck, FHI 360
Greg Guest, FHI 360

Multiple concurrent partnerships are hypothesized to be important drivers of HIV transmission. Despite the demonstrated importance of relationship type (i.e. wife, girlfriend, casual partner, sex worker) on condom use, research on concurrency has not examined how different combinations of relationship types might affect condom use. We address this gap, using survey data from a sample of men from Ghana (n=807) and Tanzania (n=800) who have at least three sexual partners in the past three months. We found that approximately two-thirds of men's reported relationships were classified as a girlfriend. Men's condom use with girlfriends was associated with his other relationship types. Men were more likely to use a condom with a girlfriend if their other partner was a wife compared to if their other partner was a sex worker (Ghana OR 3.10, 95% CI, 1.40, 6.86; Tanzania OR 2.34 95% CI 1.35, 4.06). These findings stress the importance of relationship type when examining concurrency.