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HIV risk among adolescent girls and young women in age-disparate partnerships: Evidence from KwaZulu-Natal, South Africa
  • Published Date:
    June 01 2018
  • Source:
    J Acquir Immune Defic Syndr. 78(2):155-162
  • Language:
    English
Filetype[PDF-334.95 KB]


Details:
  • Pubmed ID:
    29767637
  • Pubmed Central ID:
    PMC5968825
  • Description:
    Background

    Evidence on the role of age-disparate partnerships in high HIV-infection rates among young women in sub-Saharan Africa remains inconclusive. This study examined the HIV-infection risk associated with age-disparate partnerships among 15–24 year-old women in a hyper-endemic setting in South Africa.

    Methods

    Face-to-face questionnaire, and laboratory HIV and viral load data were collected during 2014–2015 among a representative sample (15–49 years-old) in KwaZulu-Natal. The association between age-disparate partnerships (age-difference ≥5 years) and HIV-status among 15–24 year-old women (N=1459) was assessed using multiple logistic regression analyses. Data from the male sample on all on-going partnerships (N=1229) involving 15–24 year-old women were used to assess whether young women’s age-disparate male partners were more likely to have a viral load ≥1000 copies/ml, a marker of HIV-infection risk.

    Results

    Women reporting an age-disparity in any of their three recent partnerships were more likely to test HIV-positive compared to women with only age-similar partners (aOR:1.58, 95%CI:1.20–2.09,p<0.01). Among partnerships men reported with 15–24 year old women, the age-disparate male partners were more likely to be HIV-positive and have a viral load ≥1000 copies/mL (aOR:2.05, 95%CI:1.30–3.24,p<0.01) compared to age-similar partners. Results were similar for each category of age-disparity: partners 5–9 years older (aOR:2.01, 95%CI:1.18–3.43,p=0.010) and those ≥10 years older (aOR:2.17, 95%CI:1.01–4.66,p=0.048).

    Conclusions

    Results indicate that age-disparate partnerships increase young women’s HIV risk, although conclusive evidence was not ascertained. Interventions addressing risk from age-disparate sexual partnering, including expanding antiretroviral treatment among older partners, may help to reduce HIV-incidence among young women.

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