Departments of Sociology and Statistics, Box 354322 University of Washington, Seattle, WA 98195-4322, USA.
J Int AIDS Soc. 2011 Mar 15;14:13. doi: 10.1186/1758-2652-14-13.
The strength of the evidence linking concurrency to HIV epidemic severity in southern and eastern Africa led the Joint United Nations Programme on HIV/AIDS and the Southern African Development Community in 2006 to conclude that high rates of concurrent sexual partnerships, combined with low rates of male circumcision and infrequent condom use, are major drivers of the AIDS epidemic in southern Africa. In a recent article in the Journal of the International AIDS Society, Larry Sawers and Eileen Stillwaggon attempt to challenge the evidence for the importance of concurrency and call for an end to research on the topic. However, their "systematic review of the evidence" is not an accurate summary of the research on concurrent partnerships and HIV, and it contains factual errors concerning the measurement and mathematical modelling of concurrency.Practical prevention-oriented research on concurrency is only just beginning. Most interventions to raise awareness about the risks of concurrency are less than two years old; few evaluations and no randomized-controlled trials of these programmes have been conducted. Determining whether these interventions can help people better assess their own risks and take steps to reduce them remains an important task for research. This kind of research is indeed the only way to obtain conclusive evidence on the role of concurrency, the programmes needed for effective prevention, the willingness of people to change behaviour, and the obstacles to change.
联合艾滋病规划署和南部非洲发展共同体在 2006 年得出结论，性伴关系的同时存在、男性割礼率低以及避孕套使用率低等因素结合在一起，是南部非洲艾滋病流行的主要驱动因素，这种同时存在的性伴关系与艾滋病毒流行严重程度之间的证据非常有力。在最近发表在《国际艾滋病协会杂志》上的一篇文章中，Larry Sawers 和 Eileen Stillwaggon 试图对同时存在性伴关系的重要性的证据提出质疑，并呼吁停止对这一主题的研究。然而，他们的“证据的系统综述”并不能准确地总结关于同时存在的性伴关系和艾滋病毒的研究，其中还包含关于同时存在性伴关系的测量和数学模型的错误。
关于同时存在性伴关系的面向实际预防的研究才刚刚开始。提高对同时存在性伴关系风险的认识的大多数干预措施都不到两年；对这些方案的评估和随机对照试验也很少。确定这些干预措施是否有助于人们更好地评估自己的风险并采取措施降低风险，仍然是研究的一项重要任务。这种研究确实是获得关于同时存在性伴关系的作用、有效预防所需的方案、人们改变行为的意愿以及改变行为的障碍的结论性证据的唯一途径。
