Under-reporting of partnership concurrency among married men and women in rural Uganda

Elizabeth A. Sully, Guttmacher Institute
Georges Reniers, London School of Hygiene and Tropical Medicine (LSHTM)
Fred Nalugoda, Rakai Health Sciences Program
Kenneth Ekoru, MRC/UVRI Uganda Research Unit on AIDS
Tom Lutalo, Rakai Health Sciences Program
Janet Seeley, MRC/UVRI Uganda Research Unit on AIDS and London School of Hygiene and Tropical Medicine (LSHTM)

There is an intense debate about whether concurrent partnerships are a primary driver of the high rates of HIV in Southern and Eastern Africa. One of the key limitations to testing whether concurrency affects HIV transmission is the misreporting of concurrent partnerships. Previous studies, however, have lacked biomarker data to back these claims. That is the objective of this study. Using longitudinal data from two HIV surveillance sites in rural Uganda, we assess the sensitivity of self- and partner-reported concurrency among married men and women who seroconvert while their spouse remains HIV-negative. We find evidence that underreporting of concurrency is high, particularly among women. Without addressing measurement error in reported concurrency it will be difficult, if not impossible, to empirically test the effect of partnership concurrency on HIV transmission.