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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

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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.

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Acknowledgements

The authors acknowledge the dedication of fieldworkers and research staff of the Human Sciences Research Council and partners, as well as through the contributions of study participants, who made the 2012 South African National HIV Survey possible. The authors thank Atheendar Venkataramani and David Maughan Brown for helpful comments and suggestions on previous versions of this manuscript.

Funding

This study is based on data collected as part of the 2012 South African National HIV Survey, supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC) under the terms of 5U2GGH000570. The contents of this study are solely the responsibility of the authors and do not necessarily represent the official views of CDC. Brendan Maughan-Brown acknowledges support from the National Research Foundation, South Africa, through the Research Career Advancement Fellowship.

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Authors and Affiliations

  1. Department of Anthropology, York University, 2054 Vari Hall, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada

    Meredith Evans

  2. Southern Africa Labour and Development Research Unit (SALDRU), University of Cape Town, Cape Town, South Africa

    Brendan Maughan-Brown

  3. HIV/AIDS, STIs and TB (HAST) and Office of the CEO, Human Sciences Research Council, Pretoria, South Africa

    Nompumelelo Zungu

  4. Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa

    Gavin George

Authors
  1. Meredith Evans
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  2. Brendan Maughan-Brown
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  3. Nompumelelo Zungu
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  4. Gavin George
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Corresponding author

Correspondence to Meredith Evans.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical Approval

Ethical approval for the study was obtained from the Ethics Committee of the Human Sciences Research Council (HSRC), South Africa and Centers for Disease Control (CDC), United States. All procedures performed in the study were in accordance with the ethical standards of the HSRC and CDC.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Evans, M., Maughan-Brown, B., Zungu, N. et al. 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. AIDS Behav 21, 2533–2542 (2017). https://doi.org/10.1007/s10461-017-1741-6

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  • DOI: https://doi.org/10.1007/s10461-017-1741-6

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