Multiple and concurrent sexual partnership in Malawi: a formative qualitative study

The premise that multiple concurrent sexual partnerships (MCP), coupled with inconsistent use of condoms, has been linked with increased risk of HIV infection. In places where HIV infection has shown significant signs of decline, such as in Uganda, Kenya, Zimbabwe, Zambia and Thailand, evidence strongly suggests that partner reduction has played a crucial role in infection reduction. The diversity and strength of available evidence underscore the need for efforts that promote MCP reduction as a strategy for HIV control. To design and scale up strategies that will effectively promote partner reduction and change the social norms that facilitate MCP, there is need for a strong evidence base concerning the individual predisposing factors and the socio-cultural props of the behaviour.

The findings of this study indicate that there are no simplistic patterns in terms of where community members take their cues from on sexual matters. Culture, tradition, and religion, much as they are powerful forces in shaping or moulding people’s sexual behaviours, also contain internal contradictions that influence some community members, especially the younger ones, to begin to develop their own sense of personal values, moralities, leadership and responsibility – including those related to casual, serial, monogamous and multiple sexual practices and behaviours.

On the whole, the findings of this study point to the need for a multi-faceted approach to interventions aimed at reducing MCP in different communities. Such an approach should take into consideration the specific social and material conditions prevailing in a local community.