title: Risk factors for incident HIV infection among antenatal mothers in rural Eastern Cape, South Africa.
abstract: BACKGROUND
  The prevalence of HIV among antenatal clients in South Africa has remained at a very high rate of about 29% despite substantial decline in several sub-Saharan countries. There is a paucity of data on risk factors for incident HIV infection among antenatal mothers and women within the reproductive age bracket in local settings in the Eastern Cape, South Africa.
  
  
  OBJECTIVE
  To establish the risk factors for incident HIV infection among antenatal clients aged 18-49 years attending public antenatal clinics in rural Eastern Cape, South Africa.
  
  
  METHODS
  This was an unmatched case-control study carried out in public health antenatal clinics of King Sabata District Municipality between January and March 2014. The cases comprised 100 clients with recent HIV infection; the controls were 200 HIV-negative antenatal clients. Socio-demographic, sexual, and behavioral data were collected using interviewer-administered questionnaires adapted from the standard DHS5 women's questionnaire. Multivariate logistic regression models were used to identify the independent risk factors for HIV infection. A p<0.05 was considered statistically significant.
  
  
  RESULTS
  The independent risk factors for incident HIV infection were economic dependence on the partner, having older male partners especially among women aged ≤20 years, and sex under the influence of alcohol.
  
  
  CONCLUSIONS
  Therefore, effective prevention of HIV among antenatal mothers in KSDM must target the improvement of the economic status of women, thereby reducing economic dependence on their sexual partners; address the prevalent phenomenon of cross-generation sex among women aged <20 years; and regulate the brewing, marketing, and consumption of alcohol.
authors.affiliation: Faculty of Health Sciences, Walter Sisulu University, Eastern Cape, South Africa.
authors.forename: Charles Bitamazire
authors.initials: CB
authors.lastname: Businge
authors.affiliation: Faculty of Health Sciences, Walter Sisulu University, Eastern Cape, South Africa; longombenza@gmail.com.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Longo-Mbenza
authors.affiliation: School of Public Health, University of Western Cape, Cape Town, South Africa.
authors.forename: Verona
authors.initials: V
authors.lastname: Mathews
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D011295:Prenatal Care; D015995:Prevalence; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D013019:South Africa / Q000453:epidemiology; D055815:Young Adult
keywords: HIV; South Africa; antenatal; incidence; risk factors