Multiple Partners, Marriage and Materialism: The Structural Drivers of HIV across Sixteen African Countries

Ashley Fox, Mount Sinai School of Medicine

Research has identified sexual concurrency as a major underlying driver of high HIV infection levels in sub-Saharan Africa. Whereas some researchers argue that concurrency represents a culturally sanctioned continuation with historical polygamy, ethnographic research supports dynamic economic conditions in explanations for sexual partnering patterns over static cultural explanations. This paper empirically assesses the relationship between economic conditions and sexual concurrency/polygamy among men and women in sub-Saharan Africa using Demographic and Health Surveys from sixteen countries. Wealthier men and women had higher odds of being in an extramarital partnership and living in a wealthier area was associated with a higher odds of being in a concurrent partnership. By contrast, the odds of being in a polygamous union were higher among poorer individuals and in poorer areas. Across multiple African countries, extramarital concurrency is associated with higher wealth and economic development, whereas polygamy is associated with poverty and lower economic development.