title: Sexual power and HIV risk, South Africa.
abstract: Gender power inequities are believed to play a key role in the HIV epidemic through their effects on women's power in sexual relationships. We hypothesized that lack of sexual power, measured with a four-point relationship control scale and by a woman's experience of forced sex with her most recent partner, would decrease the likelihood of consistent condom use and increase the risk for HIV infection among sexually experienced, 15- to 24-year-old women in South Africa. While limited sexual power was not directly associated with HIV, it was associated with inconsistent condom use: women with low relationship control were 2.10 times more likely to use condoms inconsistently (95% confidence interval [CI] 1.17-3.78), and women experiencing forced sex were 5.77 times more likely to use condoms inconsistently (95% CI 1.86-17.91). Inconsistent condom use was, in turn, significantly associated with HIV infection (adjusted odds ratio 1.58, 95% CI 1.10-2.27).
authors.affiliation: University of the Witwatersrand, Johannesburg, South Africa. a.pettifor@rhrujhb.co.za
authors.forename: Audrey E
authors.initials: AE
authors.lastname: Pettifor
authors.forename: Diana M
authors.initials: DM
authors.lastname: Measham
authors.forename: Helen V
authors.initials: HV
authors.lastname: Rees
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Padian
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D015999:Multivariate Analysis; D016017:Odds Ratio; D011209:Power, Psychological; D015995:Prevalence; D012307:Risk Factors; D012747:Sexual Partners / Q000523:psychology*; D013019:South Africa