Evidence that age-disparate relationships (ADR) between young women and older men are an important route of transmission of HIV infection is limited. The results from recent studies indicate that heterosexual relationships between young women and older men may help sustain the epidemic within some populations of South Africa and Malawi. However, the way in which age differences serve to sustain the epidemic of HIV may be different than what has been previously described in observational studies. This article proposes several public health intervention recommendations in relation to ADR and the epidemic of HIV.
Interventions to curb age-disparate relationships (ADR) are ongoing in spite of conflicting evidence that ADR are a risk factor for HIV transmission. There is a real need to explore the prevalence of ADR and understand what they mean for HIV transmission. We must first understand and describe these relationships; second, establish a causal relationship with HIV. We recently published a paper that explores those objectives in a population of 1,922 adult men and women living in Likoma Island, Malawi.
Concurrent partnerships have been suggested as a possible driver of the HIV epidemic in Southern Africa. To date, estimates of concurrency in published literature have been problematic due to poor definitions and measurement. We conducted a sexual behaviour survey in Cape Town that characterized concurrency by estimating the point prevalence, cumulative prevalence, incidence and degree distribution of concurrent partnerships. We also described the duration of overlaps for relationships begun in the previous year and the relative risk of having concurrent partnerships for different race and sex groups.
We would like to invite you to the Results Showcase for the Sexual Behavior Survey on Friday, 27 March, 2015 from 11am – 3pm at the Blue Hall in Khayelitsha.
Worldwide there are over 2 million third-trimester stillbirths. The lack of attention given to stillbirths may be attributed to the view that stillbirths are not preventable. There is, however, reason to believe that initiating antenatal care (ANC) early may help to prevent stillbirths in term pregnancies by preventing labour complications through early referral to skilled birth attendants, and/or by detecting and managing maternal chronic conditions and infectious diseases. The primary objective of this study was therefore to determine if the timing of the first ANC visit influences the risk of having a stillbirth in a full-term, singleton pregnancy for a population of South African women.
Young women in relationships with older men are typically at an elevated risk for acquisition of HIV in sub-Saharan Africa. Most qualitative studies have tended to focus on why women are motivated to participate in these relationships, offering little insight into perceived risks of these relationships. Therefore we conducted a qualitative study in three urban communities in Cape Town using thematic content analysis to explore women’s perceived risks of (non-)age-disparate relationships, the benefits of dating older men, and risk perceptions that influence decisions around these relationships.
Those who study sexual behaviour often rely on self-reported information from surveys. However, results from surveys may be inaccurate due to social desirability bias (SDB). One way to combat SDB is to change the mode of inquiry. Typically surveys are conducted using face-to-face-interviewing. The use of audio computer-assisted self-interviewing (ACASI) has been proposed as a better alternative. There is evidence from Africa, that use of ACASI may elicit more adequate reporting of sensitive sexual behaviours. Here we describe a sexual behaviour survey we conducted in three disadvantaged communities of Cape Town using ACASI methods.
The sexual network structure and the distribution of HIV remain inadequately understood, especially with regard to the role of concurrency and age disparity in relationships, and how these network characteristics correlate with each other and other risk factors. Additionally, sources of bias, such as social desirability bias and inaccurate recall, make it difficult to obtain Read More