Multiple Concurrent Partnerships Among Men and Women aged 15-34 in Botswana

This 53-page report, published by PSI (Population Services International) Botswana, documents the findings of a national tracking survey of youth and adults aged 15-34. The objectives of the study were to compare responses to different ways of asking about multiple concurrent partnerships (MCP); identify characteristics of MCP; and identify behavioural drivers or barriers to MCP at the individual level. Based on interviews with 1,787 youth and adults from districts across the country, the study found that approximately one quarter of the population in Botswana reports being engaged in MCP. Men are more likely than women to be involved in MCP, and knowledge about the potential risks of these kinds of relationships is low. Drivers of MCP are different for men and women and include beliefs, attitudes, self efficacy, and alcohol use.

The study also offers key recommendations for MCP interventions. According to the research, there is a clear need for MCP interventions to first prioritise addressing the gap in knowledge and risk perception that exists in relation to concurrent partnerships. For example, increasing the proportion of sexually active people aged 15-34 who identify concurrent or overlapping relationships as more risky than monogamous, spaced relationships is essential. Thereafter, the study recommends adopting different messages for men and women. It also states that HIV prevention interventions in Botswana cannot ignore the extent to which risk behaviours are driven by alcohol abuse, and MCP is no exception. Media, community, and peer-group discussion about how alcohol use or abuse increases personal HIV risk could be used to reach drinkers at times when they are sober and more receptive to messages that encourage them to reflect and take preventive measures.

The study warns that addressing deeper-seated determinants of MCP, such as peer expectations of monogamy, attitudes to sex, love, and commitment or women's lack of ability to decide on sex within relationships will be much more challenging and require more time and resources than addressing knowledge, risk, perception, and the associated cost/benefit analyses of MCP.

The study concludes that MCP interventions will not happen in isolation but in the context of other prevention activities, including condom promotion. It is essential that condom promotion is mindful of overall HIV prevention objectives and does not promote condoms as an alternative to partner reduction.