title: Age-disparate sex and HIV risk for young women from 2002 to 2012 in South Africa.
abstract: Age-disparate sex has long been considered a factor that increases HIV risk for young women in South Africa. However, recent studies from specific regions in South Africa have found conflicting evidence. Few studies have assessed the association between age-disparate partnerships (those involving an age gap of 5 years or more) and HIV risk at the national level. This study investigates the relationship between age-disparate sex and HIV status among young women aged 15-24 in South Africa.
  
  
  
  Nationally representative weighted data from the 2002, 2005, 2008, and 2012 South African National HIV Surveys were analysed for young women aged 15-24 years using bivariate analyses and multiple logistic regressions.
  
  
  
  After conducting multiple logistic regression analyses and controlling for confounders, young women with age-disparate partners had greater odds of being HIV positive in every survey year: 2002 (aOR = 1.74, 95%CI: 0.81-3.76, p = 0.16); 2005 (aOR = 2.11, 95%CI: 1.22-3.66, p < 0.01); 2008 (aOR = 2.02, 95%CI: 1.24-3.29, p < 0.01); 2012 (aOR = 1.53, 95%CI: 0.92-2.54, p < 0.1). The odds of being HIV positive increased for each year increase in their male partner's age in 2002 (aOR = 1.10, 95%CI: 0.98-1.22, p = 0.11), 2005 (aOR = 1.10, 95%CI: 1.03-1.17, p < 0.01), 2008 (aOR = 1.08, 95%CI: 1.01-1.15, p < 0.05), and 2012 (aOR = 1.08, 95%CI: 1.01-1.16, p < 0.05). Findings were statistically significant (p < 0.1) for the years 2005, 2008, and 2012.
  
  
  
  Our findings suggest that age-disparate sex continues to be a risk factor for young women aged 15-24 in South Africa at a national level. These results may reflect variation in HIV risk at the national level compared to the differing results from recent studies in a demographic surveillance system and trial contexts. In light of recent contradictory study results, further research is required on the relationship between age-disparate sex and HIV for a more nuanced understanding of young women's HIV risk.
authors.affiliation: Department of Anthropology, York University, Toronto, Canada.
authors.forename: Meredith
authors.initials: M
authors.lastname: Evan
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Risher
authors.affiliation: HIV/AIDS, STIs and TB (HAST) Programme, Human Sciences Research Council, Cape Town, South Africa.
authors.forename: Nompumelelo
authors.initials: N
authors.lastname: Zungu
authors.affiliation: Evidence Based Solutions, Cape Town, South Africa.|Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
authors.forename: Olive
authors.initials: O
authors.lastname: Shisana
authors.affiliation: HIV/AIDS, STIs and TB (HAST) Programme, Human Sciences Research Council, Cape Town, South Africa.
authors.forename: Sizulu
authors.initials: S
authors.lastname: Moyo
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: David D
authors.initials: DD
authors.lastname: Celentano
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) Programme, Human Sciences Research Council, Cape Town, South Africa.|School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Rehle
mesh_terms: D000293:Adolescent; D000328:Adult; D000375:Aging; D044383:Black People; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D013019:South Africa / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Age-disparate sex; HIV; South Africa; intergenerational sex; sexual behaviour; women