Do age-disparate relationships drive HIV incidence in young women?

Journal of Acquired Immune Deficiency Syndromes

Harling, Guy ScD; Newell, Marie-Louise PhD,‡; Tanser, Frank PhD; Kawachi, Ichiro MD, PhD; Subramanian, S.V. PhD; Bärnighausen, Till MD, ScD

Do Age-Disparate Relationships Drive HIV Incidence in Young Women? Evidence from a Population Cohort in Rural KwaZulu-Natal, South Africa

Ethnographic investigations and mathematical models suggest that older sexual partners are often considered a major risk factor for HIV for young women in sub-Saharan Africa.

Using data from a population cohort in rural KwaZulu-Natal, South Africa, the authors studied 15-29 year-old women who were HIV seronegative at first interview from January 2003 – June 2012. They used proportional hazards analysis to establish whether the age disparity of the women’s most recent sexual partner, updated at each surveillance round, was associated with subsequent HIV acquisition.

The results showed that while HIV incidence in young women was very high in KwaZulu-Natal, partner age disparity did not predict HIV acquisition. Campaigns to reduce age-disparate sexual relationships may not be a cost-effective use of HIV prevention resources in this setting. 

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