Factors associated with HIV sero-positivity in young, rural South African men.
OBJECTIVE
To describe factors associated with HIV infection in men aged 15-26 years.


METHODS
Rural Eastern Cape Province, South Africa.


METHODS
A total of 1277 sexually experienced Xhosa male volunteers from 70 villages participating in a cluster randomized controlled trial of an HIV behavioural intervention. Xhosas circumcise during manhood initiation rituals.


METHODS
Cross-sectional, analysis of the study's baseline interviews.


METHODS
HIV sero-status, sexual practices measured with an interviewer-administered questionnaire.


RESULTS
About 2% of the men were HIV positive. A logistic regression model showed HIV positivity to be associated with age (OR 1.55; 95%CI 1.22-1.95), having made a woman pregnant (OR 2.93; 95% CI 1.28-6.68), having been circumcised (OR 0.40; 95% CI 0.16-0.98), and having had sex with a man (OR 3.61; 95% CI 1.0-13.0).


CONCLUSIONS
Our findings provide further evidence to suggest that circumcision is protective. There was much heterosexual risk taking among men but only pregnancy (with its association with sexual frequency) predicted HIV sero-positivity. Although relatively rare, same-sex sexual experiences were a risk factor. Male-male sexual contact is rarely assessed in HIV research in Africa and almost never addressed in general HIV prevention programming. Our findings suggest that it should be given more attention.
Jewkes
R
R
Gender & Health Research Unit, Medical Research Council, Private Bag X385, Pretoria 0001, South Africa. rjewkes@mrc.ac.za
Dunkle
K
K
Nduna
M
M
Levin
J
J
Jama
N
N
Khuzwayo
N
N
Koss
M
M
Puren
A
A
Duvvury
N
N
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002944:Circumcision, Male; D003430:Cross-Sectional Studies; D006679:HIV Seropositivity / Q000453:epidemiology* / Q000523:psychology; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012423:Rural Health; D012725:Sexual Behavior; D012747:Sexual Partners; D013019:South Africa / Q000453:epidemiology