title: Characteristics of Age-Discordant Partnerships Associated With HIV Risk Among Young South African Women (HPTN 068).
abstract: Sexual liaisons between older men and younger women have been linked to greater risk of HIV acquisition. This study aims to (1) identify psychosocial and behavioral factors associated with age-discordant (partner ≥5 years) versus age-concordant partnerships (-1< partner <5) and (2) examine the association between partner age discordance and young South African women's sexual behavior.
  
  
  
  We used generalized estimating equations to analyze responses from 656 sexually experienced women (aged 13-20 years) from rural Mpumalanga province.
  
  
  
  Partner age discordance was associated with greater odds of reporting both more frequent sex [adjusted odd ratio (aOR) = 1.77; 95% confidence interval (CI): 1.20 to 2.60] and having a partner with concurrent partnerships (aOR = 1.77; 95% CI: 1.22 to 2.57). Age-discordant partnerships were associated with greater odds of casual partnerships (aOR = 1.50; 95% CI: 1.06 to 2.13), having a partner with concurrent partnerships (aOR = 1.71; 95% CI: 1.19 to 2.46), and more frequent intercourse (ie, having sex at least 2 or 3 times per month) (aOR = 2.04; 95% CI: 1.39 to 3.00). They were associated with lower odds of reporting condom use at last sex (aOR = 0.70; 95% CI: 0.50 to 0.98) and always using condoms (aOR = 0.53; 95% CI: 0.32 to 0.88) in age-discordant partnerships.
  
  
  
  Our findings suggest that a history of age-discordant partnerships, and to a lesser extent having an age-discordant partner, is linked to HIV risk among young South African women; however, the link between partner age discordance and HIV risk may be more strongly related to the characteristics of age-discordant partnerships than to the characteristics of young women who form such partnerships.
authors.affiliation: *Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC; †Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA; ‡Public Health Sciences Division, Fred Hutchinson Cancer Research Institute, Seattle, WA; §Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; ‖Collaborative Research Network in Mental Health and Well-being in Rural and Regional Communities, University of New England, Armidale, Australia; ¶MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; #Carolina Population Center, University of North Carolina, Chapel Hill, NC; and **Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Tiarney D
authors.initials: TD
authors.lastname: Ritchwood
authors.forename: James P
authors.initials: JP
authors.lastname: Hughes
authors.forename: Larissa
authors.initials: L
authors.lastname: Jennings
authors.forename: Catherine
authors.initials: C
authors.lastname: MacPhail
authors.forename: Brian
authors.initials: B
authors.lastname: Williamson
authors.forename: Amanda
authors.initials: A
authors.lastname: Selin
authors.forename: Kathleen
authors.initials: K
authors.lastname: Kahn
authors.forename: F Xavier
authors.initials: FX
authors.lastname: Gómez-Olivé
authors.forename: Audrey
authors.initials: A
authors.lastname: Pettifor
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D044383:Black People; D017280:Condoms / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000523:psychology / Q000635:transmission*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data; D012747:Sexual Partners / Q000145:classification* / Q000523:psychology*; D013019:South Africa / Q000453:epidemiology; D047568:Unsafe Sex / Q000523:psychology; D055815:Young Adult