A number of sexually transmitted infections (STIs) persist for a considerably shorter period in the male urethra than the vagina. If the gap between sequential partnerships is longer than the duration of STI colonization in males, then this would protect future female partners from this STI in a setting of serial monogamy. If, however, males have more than one partner at a time (concurrency), then this would enable the STI to bypass this gap/buffer. We therefore propose bypassing the rapid-clearance-in-males-buffer as a fourth mechanism, whereby concurrency could enhance the spread of STIs.
Morris M, Goodreau S and Moody J. Sexual networks, concurrency and STD/HIV. In: Holmes KK (ed.) Sexually transmitted disease. 4th ed. New York: McGraw-Hill Medical, 2008, pp.109–127.
2.
HamiltonDTMorrisM. The racial disparities in STI in the U.S.: concurrency, STI prevalence, and heterogeneity in partner selection. Epidemics2015; 11: 56–61.
3.
MorrisMKretzschmarM. Concurrent partnerships and the spread of HIV. AIDS1997; 11: 641–648.
4.
World Health Organization. Global prevalence and incidence of selected curable sexually transmitted infections: overview and estimates, Geneva: WHO, 2001.
5.
Hobbs MM, Seña AC, Swygard H, et al. Trichomonas vaginalis and trichomoniasis. Sex Transm Dis 2008; 35: 771–793.
6.
FordLCHammillHADeLangeRJet al.Determination of estrogen and androgen receptors in Trichomonas vaginalis and the effects of antihormones. Am J Obstet Gynecol1987; 156: 1119–1121.
7.
HorvathovaLSafarikovaLBaslerMet al.Transcriptomic identification of iron-regulated and iron-independent gene copies within the heavily duplicated Trichomonas vaginalis genome. Genome Biol Evol2012; 4: 1017–1029.
8.
SchwebkeJRRiversCLeeJ. Prevalence of Gardnerella vaginalis in male sexual partners of women with and without bacterial vaginosis. Sex Transm Dis2009; 36: 92–94.
9.
LamMHBirchDF. Survival of Gardnerella vaginalis in human urine. Am J Clin Pathol1991; 95: 234–239.
10.
Kenyon CR, Buyze J, Klebanoff M, et al. Association between bacterial vaginosis and partner concurrency: a longitudinal study. Sex Transm Infect. Epub ahead of print 19 September 2016. DOI: 10.1136/sextrans-2016-052652.
11.
KenyonCRColebundersR. Strong association between the prevalence of bacterial vaginosis and male point-concurrency. Eur J Obstet Gynecol Reprod Biol2014; 172: 93–96.
12.
KenyonCRHamiltonDT. Correlation between Trichomonas vaginalis and concurrency: an ecological study. Interdiscip Perspect Infect Dis2016; 2016: 5052802–5052802.
13.
CanchihuamanFACarcamoCPGarciaPJet al.Non-monogamy and risk of infection with Chlamydia trachomatis and Trichomonas vaginalis among young adults and their cohabiting partners in Peru. Sex Transm Dis2010; 86: iii37–iii44.
14.
JohnsonLFGeffenN. A comparison of two mathematical modeling frameworks for evaluating sexually transmitted infection epidemiology. Sex Transm Dis2016; 43: 139–146.
15.
BuimerMvan DoornumGJChingSet al.Detection of Chlamydia trachomatis and Neisseria gonorrhoeae by ligase chain reaction-based assays with clinical specimens from various sites: implications for diagnostic testing and screening. J Clin Microbiol1996; 34: 2395–2400.
16.
KorenrompELSudaryoMKde VlasSJet al.What proportion of episodes of gonorrhoea and chlamydia becomes symptomatic?Int J STD AIDS2002; 13: 91–101.
17.
PotteratJJZimmerman-RogersHMuthSQet al.Chlamydia transmission: concurrency, reproduction number, and the epidemic trajectory. Am J Epidemiol1999; 150: 1331–1339.
18.
GhaniACSwintonJGarnettGP. The role of sexual partnership networks in the epidemiology of gonorrhea. Sex Transm Dis1997; 24: 45–56.
19.
BrotmanRMKlebanoffMANanselTRet al.Bacterial vaginosis assessed by Gram stain and diminished colonization resistance to incident gonococcal, chlamydial, and trichomonal genital infection. J Infect Dis2010; 202: 1907–1915.
20.
CherpesTLMeynLAKrohnMAet al.Association between acquisition of herpes simplex virus type 2 in women and bacterial vaginosis. Clin Infect Dis2003; 37: 319–325.
21.
RottingenJACameronDWGarnettGP. A systematic review of the epidemiologic interactions between classic sexually transmitted diseases and HIV: how much really is known?Sex Transm Dis2001; 28: 579–597.
