SHORT REPORT: Social and cultural contexts of concurrency in a township in Cape Town, South Africa

Understanding the social and cultural context in which concurrent sexual partnerships exist is important, given recent interventions to reduce their prevalence. This qualitative study seeks to improve the understanding of concurrent partnerships and perceptions of the link between concurrency and HIV risk in a South African township in Cape Town. Small-group discussion and focus-group participants reported that concurrency was a common phenomenon in their township. The most commonly cited reasons for participating in concurrent partnerships were material and financial exchange or gain and sexual dissatisfaction with partners. Although participants believed that being in a concurrent relationship increases the risk of acquiring HIV, they did not believe this discourages many people from engaging in these behaviours. This study highlights that concurrency in this context may be a social norm that is resistant to change. The efficacy of current programmes aimed at reducing concurrency needs to be examined in this context. Our findings suggest that improving economic independence at the individual level and improving sexual satisfaction within partnerships may have some leverage for concurrency reduction. An alternative approach to strengthen combination HIV-prevention strategies could be to increase condom use with the additional/side partners, whose predominant role is often perceived in terms of sex, with messages centred on the notion that sex with additional partner(s) should not endanger the main partner. Étant donné les récentes interventions pour en réduire la prévalence, il est important de comprendre le contexte dans lequel les partenariats sexuels parallèles existent. Cette étude qualitative vise à approfondir les connaissances sur ces partenariats parallèles et les perceptions sur le lien entre leur concomitance et le risque lié au VIH dans un township du Cap, en Afrique du Sud. Des participants à de petits groupes de discussion et à des groupes de discussion thématique ont déclaré que les relations parallèles étaient un phénomène courant dans leur township. Les justifications pour ce type de partenariats le plus souvent exprimées ont été les échanges ou les avantages matériels et financiers, et l'insatisfaction sexuelle avec les partenaires. Bien que les participants aient cru à l'augmentation du risque lié au VIH à travers les partenariats parallèles, ils ne considéraient pas cette croyance comme un facteur suffisamment dissuasif vis-à-vis de ces