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Gendered sexual risk patterns and polygamy among HIV sero-discordant couples in Uganda


Multiple sexual partnerships and HIV sero-discordant relationships are among the most at-risk for HIV transmission. Polygamy is a common form of multiple-partnered relationships in Eastern Uganda. We investigated the association between HIV risk patterns and polygamy among HIV sero-discordant couples at The AIDS Support Organization in Jinja, Uganda Methods Participants were enrollees in a prospective cohort of HIV sero-discordant couples, the Highly Active Antiretroviral therapy as Prevention (HAARP) Study at TASO Jinja. Descriptive and bivariate analyses to compare sexual risk patterns among HIV sero-discordant men; in polygamous as compared to single-spouse relationship.


Polygamous Vs Single-spouse couples ≥2 wives 1 wife P value N = 241 56 185 Male HIV+ve 38 (68%) 99 (54%) 0.065 Male-controlled sexual decision making 34 (61%) 66 (36%) 0.001 Male-controlled condom use 33 (59%) 51 (28%) <0.001 Condom last time had sex 45 (80%) 128 (69%) 0.086 Financial support 45 (80%) 152 (82%) 1.00 HIV positive partner on ART 24 (37%) 88 (48%) 0.143 Median age (IQR) 44 (39– 50) 43 (37– 50) 0.451.


This study demonstrates continued gendered risks for women in HIV sero-discordant relationships in sub-Saharan Africa. In particular, men with 2 or more wives are more likely to make decisions about when to have sex or when to use a condom. However, we found no differences in condom use at last sex by polygamy status.

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Correspondence to Sarah Khanakwa.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Khanakwa, S., Ngolobe, M., Moore, D. et al. Gendered sexual risk patterns and polygamy among HIV sero-discordant couples in Uganda. Retrovirology 9 (Suppl 1), P103 (2012).

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