Friendship networks and HIV risk among young women in South Africa - Elizabeth Fearon

Friends could be an important influence on young women’s risk of acquiring HIV; they serve as a channel for dominant norms about gender and sexuality and are the social contacts through which young women form sexual partnerships. Research from other populations has found that the characteristics of adolescents’ friends can affect a range of health-related behaviours, including sexual behaviour.

While existing evidence from sub-Saharan Africa suggests that peers might be influential, the quantitative evidence base is weak and there has not previously been a study that uses HIV as an outcome. Social network analysis explicitly focuses on the relationships through which influence on behaviour might flow and recognises how an individual’s position within a broader relational network might change their exposure to influences. This approach has been usefully employed to study sexual behaviour in other populations, but not yet in sub-Saharan African adolescents.

In 2011, young women participating in the HPTN 068 Swa Koteka Conditional Cash Transfer trial in rural northeast South Africa were asked to describe their friendships in detail in an egocentric social network study. The results showed that friends' characteristics were associated with:

  • young women’s likelihood of being HIV positive and/or having Herpes Simplex Type 2 virus
  • the age of her sexual partners
  • her likelihood of being sexually active.

Introduced by Dr Nambusi Kyegombe, this talk describes the approach to studying young women’s friendships, key findings and the implications for HIV prevention. 

Dr Elizabeth Fearon is an epidemiologist at the London School of Hygiene and Tropical Medicine. She works on HIV/AIDS in Sub-Saharan Africa and is interested in how social factors affect HIV risk and how we can measure these factors. Her work uses social network analysis to describe and investigate how the web of relationships an individual is embedded in can affect their risk of exposure to, or protection from HIV.

Download the presentation pdf here.


Is the sexual behaviour of young people in sub-Saharan Africa influenced by their peers? A systematic review

Associations between friendship characteristics and HIV and HSV-2 status amongst young South African women in HPTN-068

Friendships Among Young South African Women, Sexual Behaviours and Connections to Sexual Partners


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