Do behavioural differences help to explain variations in HIV prevalence in adolescents in sub-Saharan Africa?
To compare adolescent risk factors for HIV infection in two countries with high adolescent HIV prevalence and two lower prevalence countries with the aim of identifying risk factors that may help explain differences in adolescent HIV prevalence. Methods
Data were available from two nationally representative surveys (South Africa, Zimbabwe), two behavioural intervention trials (Tanzania, Zimbabwe) and one population-based cohort (Uganda). Data on variables known or postulated to be risk factors for HIV infection were compared. Results
Few risk behaviours were markedly more common in the high HIV prevalence populations. Risk factors more common in high HIV prevalence settings were genital ulcers and discharge, and women were more likely to report older male partners. Discussion
Age mixing may be an important determinate of HIV prevalence in adolescents. Potential reasons for the general lack of association between other adolescent risk factors and adolescent HIV prevalence include adult HIV prevalence, misreported behaviour, different survey methods and other unmeasured adolescent behaviours. If adult factors dominate adolescent HIV risk, it would help explain the failure of behavioural interventions targeted at adolescents and suggests future interventions should include adults.
Document Type: Research Article
Affiliations: 1: London School of Hygiene and Tropical Medicine, UK 2: MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda 3: Reproductive Health and HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa 4: Ministry of Health and Child Welfare, AIDS and TB Unit, Harare, Zimbabwe 5: Centre for Sexual Health and HIV Research, University College London, UK 6: Institute of Tropical Medicine, Antwerp, Belgium
Publication date: 01 May 2010