Essential Knowledge

Multiple and concurrent sexual partnerships (MCP) are widely held to be one of the primary drivers of the HIV epidemic, especially in sub-Saharan Africa. Concurrent sexual partnerships potentially increase the spread of HIV by creating more connected sexual networks, reducing the time until onward HIV transmission after acquisition, and eliminating the ‘protective sequencing’ provided by serial monogamy. Many researchers, programmers and policymakers feel that reducing concurrency and increasing awareness of the risks associated with MCP should be a major focus of HIV prevention programs and communication campaigns. Understanding the varieties and patterns of sexual relationships is a necessary element in implementing effective prevention programs.

In addition to understanding the socio-cultural factors of MCP, researchers also need to define standardized, reliable and feasible methods for measuring MCP. Scientists still need to refine the methods for measuring and comparing sexual norms, behaviors, and networks in diverse cultural contexts and risk settings. Good tools for measuring MCP will allow for understanding the prevalence of MCP and monitoring and evaluation of MCP reduction programs.  Moreover, consistent and shared terminology is important when defining and measuring MCP:

Multiple sexual partnerships: having more than one sexual partner over a period of time. These can be either serial partners (one after the other), or concurrent partners (different sexual partners that overlap in time).

Concurrent sexual partnerships: overlapping sexual partnerships where sexual intercourse with one partner occurs between two acts of intercourse with another partner. Concurrent partnerships may refer to an overlapping combination of one's main partner with another partner or can include intermittent or occasional sexual contacts, as well as one-off sexual relationships (sex worker, casual encounter). 

This section of the MCP Toolkit provides key resources on mutiple sexual partnerships, with a focus on the risks associated with concurent sexual partnerships and large sexual networks.  

Terminology
The abundance of terminology used to identify and describe concurrent sexual partnerships has been a source of confusion for researchers and programmers alike. The acronym ‘MCP’, used in some literature to refer to ‘Multiple and Concurrent Partnerships’, is a phrase used to discuss the correlated but not identical risk behaviors of having multiple sexual partners and having concurrent sexual partners. In other instances MCP is an acronym for the phrase ‘Multiple Concurrent Partnerships’, for which the definition is ambiguous, but is often used as a synonym for ‘concurrent sexual partnerships.’ Due to the ambiguity around the meaning of ‘MCP’, it is recommended that this acronym is not used to identify or describe concurrency, preferring the phrases ‘concurrent sexual partnerships’, ‘concurrent partnerships’, or simply ‘concurrency’.  At present, this toolkit uses the acronym 'MCP' to refer to concurrent relationships; but as more evidence becomes available, the terminology will be updated to reflect relevant changes in semantics.