title: The case for expanding the definition of 'key populations' to include high-risk groups in the general population to improve targeted HIV prevention efforts.
abstract: BACKGROUND
  Two additional key populations within the general population in South Africa (SA) that are at risk of HIV infection are black African women aged 20 - 34 years and black African men aged 25 - 49 years.
  
  
  OBJECTIVE
  To investigate the social determinants of HIV serostatus for these two high-risk populations.
  
  
  METHODS
  Data from the 2012 South African National HIV Prevalence, Incidence, and Behaviour Survey were analysed for black African women aged 20 - 34 years and black African men aged 25 - 49 years.
  
  
  RESULTS
  Of the 6.4 million people living with HIV in SA in 2012, 1.8 million (28%) were black women aged 20 - 34 years and 1.9 million (30%) black men aged 25 - 49 years. In 2012, they constituted 58% of the total HIV-positive population and 48% of the newly infected population. Low socioeconomic status (SES) was strongly associated (p&lt;0.001) with being HIV-positive among black women aged 20 - 34 years, and was marginally significant among black men aged 25 - 49 years (p&lt;0.1).
  
  
  CONCLUSIONS
  Low SES is a critical social determinant for HIV infection among the high-risk groups of black African women aged 20 - 34 years and black African men aged 25 - 49 years. Targeted interventions for these key populations should prioritise socioeconomic empowerment, access to formal housing and services, access to higher education, and broad economic transformation.
authors.affiliation: HSRC. oshisana@hsrc.ac.za.
authors.forename: Olive
authors.initials: O
authors.lastname: Shisana
authors.forename: N
authors.initials: N
authors.lastname: Zungu
authors.forename: M
authors.initials: M
authors.lastname: Evans
authors.forename: K
authors.initials: K
authors.lastname: Risher
authors.forename: T
authors.initials: T
authors.lastname: Rehle
authors.forename: D
authors.initials: D
authors.lastname: Clementano