title: HIV Prevalence and ART Use Among Men in Partnerships with 15-29 Year Old Women in South Africa: HIV Risk Implications for Young Women in Age-Disparate Partnerships.
abstract: This study assesses whether men's ART use mitigates HIV-risk within age-disparate partnerships. Using data from the 2012 South African National HIV survey, we analyzed differences in HIV prevalence and ART use between men in age-disparate and age-similar partnerships with young women aged 15-29 using multiple logistic regression analyses. Within partnerships involving women 15-24 years old, men in age-disparate partnerships were more likely to be HIV-positive (5-9 year age-gap: aOR 2.8, 95%CI 1.4-5.2; p < 0.01; 10+ year age-gap: aOR 2.2, 95%CI 1.0-4.6; p < 0.05). Men in age-disparate partnerships who were 5-9 years older were significantly more likely to be HIV-positive and ART-naïve (aOR 2.4, 95%CI 1.2-4.8; p < 0.05), while this was not the case for men 10+ years older (aOR 1.5, 95%CI 0.7-3.6; p = 0.32). No evidence was found that 25-29 year old women were at greater HIV-risk in age-disparate partnerships. Our results indicate that young women aged 15-24 have a greater likelihood of exposure to HIV through age-disparate partnerships, but ART use among men 10+ years older could mitigate risk.
authors.affiliation: Department of Anthropology, York University, 2054 Vari Hall, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada. mgbevans@yorku.ca.
authors.forename: Meredith
authors.identifier: http://orcid.org/0000-0002-9986-3185
authors.initials: M
authors.lastname: Evans
authors.affiliation: Southern Africa Labour and Development Research Unit (SALDRU), University of Cape Town, Cape Town, South Africa.
authors.forename: Brendan
authors.initials: B
authors.lastname: Maughan-Brown
authors.affiliation: HIV/AIDS, STIs and TB (HAST) and Office of the CEO, Human Sciences Research Council, Pretoria, South Africa.
authors.forename: Nompumelelo
authors.initials: N
authors.lastname: Zungu
authors.affiliation: Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Gavin
authors.initials: G
authors.lastname: George
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D019380:Anti-HIV Agents / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D013019:South Africa / Q000453:epidemiology; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: Age-disparate partnerships; HIV; Intergenerational partnerships; Sexual behaviour; South Africa