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HIV incidence and a...
HIV incidence and associated risk factors in adolescent girls and young women in South Africa : A population-based cohort study
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- Lewis, Lara (författare)
- University of KwaZulu-Natal
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- Kharsany, Ayesha B.M. (författare)
- University of KwaZulu-Natal
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- Humphries, Hilton (författare)
- University of KwaZulu-Natal
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- Maughan-Brown, Brendan (författare)
- University of Cape Town
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- Beckett, Sean (författare)
- University of KwaZulu-Natal
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- Govender, Kaymarlin (författare)
- University of KwaZulu-Natal
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Cawood, Cherie (författare)
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Khanyile, David (författare)
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- George, Gavin (författare)
- Lund University,Lunds universitet,Socialmedicin och global hälsa,Forskargrupper vid Lunds universitet,Social Medicine and Global Health,Lund University Research Groups,University of KwaZulu-Natal
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(creator_code:org_t)
- 2022-12-21
- 2022
- Engelska.
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:12 December
- Relaterad länk:
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http://dx.doi.org/10... (free)
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- Background In sub-Saharan Africa, high HIV incidence rates in adolescent girls and young women (AGYW) persist despite extensive HIV prevention efforts. Methods A prospective cohort of 2,710 HIV-negative AGYW (15–24 years) in KwaZulu-Natal, South Africa were interviewed at baseline and followed-up approximately 18 months later (2014–2017). Associations between HIV seroconversion and socio-demographic and behavioural variables measured at baseline and follow-up were examined using Cox regression and a proximate determinants framework. Inter-relationships between determinants were measured using logistic regression. Separate models were built for 15–19 and 20-24-year-olds. Results Weighted HIV incidence was 3.92 per 100 person-years (95% confidence interval: 3.27–4.69; 163 seroconversions over 4,016 person-years). Among 15-19-year-olds, absence of family support (adjusted hazards ratio (aHR): 3.82 (1.89–7.72)), having a circumcised partner (aHR: 0.5 (0.27–0.94)) or one who was HIV-positive and not on antiretroviral therapy (ART) (aHR: 6.21 (2.56–15.06)) were associated with HIV incidence. Those reporting an absence of family support were also more likely to report >1 partner during follow-up (odds ratio (OR): 2.7(1.11–6.57)). Among 20-24-year-olds, failure to complete secondary school (aHR: 1.89 (1.11–3.21)), inconsistent condom use (aHR: 3.01 (1.14–7.96)) and reporting partner(s) who were HIV-positive and not on ART (aHR: 7.75 (3.06–19.66)) were associated with HIV incidence. Failure to complete secondary school among 20-24-year-olds was associated with inconsistent condom use (OR: 1.82 (1.20–2.77)) and reporting an HIV-positive partner not on ART (OR: 3.53(1.59–7.82)) or an uncircumcised partner (OR: 1.39 (1.08–1.82). Conclusion Absence of family support and incomplete schooling are associated with risky sexual behaviours and HIV acquisition in AGYW. In addition, partner-level prevention—condom use, medical circumcision, and viral suppression–continue to play an important role in reducing HIV risk in AGYW. These findings support the use of combination HIV prevention programs that consider structural as well as biological and behavioural HIV risk factors in their design.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
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