Individuals across Africa may have changed their sexual behaviour following the visibility of AIDS in the public sphere in the mid to late 1990s. Though each change in behaviour may have been small, the changes affected simultaneously different aspects of individual sexuality, and added up cumulatively into a moderate reduction in sexual behaviour at the individual level. In turn, this change in individual behaviour was translated into massive disruption of sexual networks at the population level. This made it difficult for HIV to propagate in the population leading to large declines in HIV incidence and prevalence.
Concurrent partnerships have been suggested as a possible driver of the HIV epidemic in Southern Africa. To date, estimates of concurrency in published literature have been problematic due to poor definitions and measurement. We conducted a sexual behaviour survey in Cape Town that characterized concurrency by estimating the point prevalence, cumulative prevalence, incidence and degree distribution of concurrent partnerships. We also described the duration of overlaps for relationships begun in the previous year and the relative risk of having concurrent partnerships for different race and sex groups.
Those who study sexual behaviour often rely on self-reported information from surveys. However, results from surveys may be inaccurate due to social desirability bias (SDB). One way to combat SDB is to change the mode of inquiry. Typically surveys are conducted using face-to-face-interviewing. The use of audio computer-assisted self-interviewing (ACASI) has been proposed as a better alternative. There is evidence from Africa, that use of ACASI may elicit more adequate reporting of sensitive sexual behaviours. Here we describe a sexual behaviour survey we conducted in three disadvantaged communities of Cape Town using ACASI methods.