title: Inkwari: an emerging high-risk place potentiating hiv spread among young adults in a hyper-endemic South African setting.
abstract: Young adults in South Africa are at the epicenter of the HIV epidemic. The prevalence of HIV among young people in the province of KwaZulu-Natal (KZN) is particularly high. This study characterizes inkwari (Zulu word for raves or weekend-long parties) in eThekwini District, KZN and explored how these place-based dynamics shape the risk environment for the young adult attendees. In 2011, 13 qualitative interviews were conducted with men and women between 18 and 30 years-old who reported unprotected sex with at least one casual partner in the prior 3 months and attended an inkwari in the same time period. Interviews were analyzed using qualitative content analysis. Nine key informant interviews helped to triangulate these data. Five women and eight men were interviewed and the mean age was 25 years (SD 3.24). Ten reported meeting a sexual partner at an inkwari. Inkwari were characterized as sexualized settings with limited adult supervision. Participants attended inkwari to socialize with peers, use drugs and alcohol, and meet sexual partners. Sexual and physical violence also occurred at inkwari. Given the convergence of social, sexual, and substance-using networks at inkwari, further inquiry is needed to determine how this place may potentiate HIV transmission risk in an endemic setting.
authors.affiliation: Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, 1 Bowdoin Square, 7th Floor, Boston, MA, 02114, USA, mmimiaga@partners.org.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Mimiaga
authors.forename: Elizabeth F
authors.initials: EF
authors.lastname: Closson
authors.forename: Steven A
authors.initials: SA
authors.lastname: Safren
authors.forename: Zonke
authors.initials: Z
authors.lastname: Mabude
authors.forename: Nzwakie
authors.initials: N
authors.lastname: Mosery
authors.forename: Scott W
authors.initials: SW
authors.lastname: Taylor
authors.forename: Amaya
authors.initials: A
authors.lastname: Perez-Brumer
authors.forename: Lynn T
authors.initials: LT
authors.lastname: Matthews
authors.forename: Christina
authors.initials: C
authors.lastname: Psaros
authors.forename: Abigail
authors.initials: A
authors.lastname: Harrison
authors.forename: David J
authors.initials: DJ
authors.lastname: Grelotti
authors.forename: David R
authors.initials: DR
authors.lastname: Bangsberg
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Smit
mesh_terms: D000293:Adolescent; D000328:Adult; D003615:Dancing; D019353:Endemic Diseases; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D015995:Prevalence; D036301:Qualitative Research; D012309:Risk-Taking; D012747:Sexual Partners; D013019:South Africa / Q000453:epidemiology; D047568:Unsafe Sex; D055815:Young Adult
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