It takes a village - Understanding concurrent sexual partnerships in Seattle, Washington

Background: Sexually transmitted infections (STIs) are efficiently spread via concurrent partnerships. Goal: This study identifies patterns of concurrency in Seattle STI clinics and community samples to enhance partner notification and counseling. Study Design: Semistructured interviews with heterosexuals (108 with gonorrhea, chlamydial infection, or nongonococcal urethritis and 120 from high STI prevalence and randomly selected neighborhoods) were tape-recorded, transcribed, and analyzed for content. Results: Six main forms of concurrency were identified: experimental, separational, transitional, reciprocal, reactive, and compensatory. Experimental concurrency, overlapping short-term partnerships, was most common. Men practiced concurrency to avoid becoming partnerless during partnership disintegration; more women, especially STI patients, reported reactive concurrency, recruiting new partners rather than leaving partners with other partners. Concurrency clustered by age and when occurring during separation and transitioning between partners was socially acceptable. Conclusions: Prevalence of concurrent partnerships in all groups studied suggests linkages to individuals' life stage and some social acceptability. STI programs should develop prevention messages to reflect different forms of concurrency.