Sexual Behaviour of Men and Women within Age-Disparate Partnerships in South Africa: Implications for Young Women's HIV Risk
Identifieur interne : 003950 ( Ncbi/Merge ); précédent : 003949; suivant : 003951Sexual Behaviour of Men and Women within Age-Disparate Partnerships in South Africa: Implications for Young Women's HIV Risk
Auteurs : Brendan Maughan-Brown [Afrique du Sud] ; Meredith Evans [Afrique du Sud] ; Gavin George [Afrique du Sud]Source :
- PLoS ONE [ 1932-6203 ] ; 2016.
Abstract
Age-disparate partnerships are hypothesized to increase HIV-risk for young women. However, the evidence base remains mixed. Most studies have focused only on unprotected sex among women in the partnership. Consequently, little is known about other risky behaviours, such as transactional sex, alcohol use, and concurrency, as well as the behaviours of the men who partner with young women. We therefore examined differences in various sexual behaviours of both young women and their male partners by partnership age difference.
We used nationally representative data from South Africa (2012) on partnerships reported by 16–24 year old black African women (n = 818) and by black African men in partnerships with 16–24 year old women (n = 985). We compared sexual behaviours in age-disparate partnerships and age-similar partnerships, using multiple logistic regression to control for potential confounders and to assess rural/urban differences.
Young women in age-disparate partnerships were more likely to report unprotected sex than young women in similar-aged partnerships (aOR:1.51; p = 0.014; 95%CI:1.09–2.11). Men in partnerships with young women were more likely to report unprotected sex (aOR:1.92; p<0.01; 95%CI:1.31–2.81), transactional sex (aOR:2.73; p<0.01; 95%CI:1.64–4.56), drinking alcohol before sex (aOR:1.60; p = 0.062; 95%CI:0.98–2.61), and concurrency (aOR:1.39; p = 0.097; 95%CI:0.94–2.07) when their partners were five or more years younger. The association between age-disparate partnerships and transactional sex (aOR:4.14; p<0.01; 95%CI: 2.03–8.46) and alcohol use (aOR:2.24; p<0.013; 95%CI:1.20–4.19) was only found in urban areas.
Results provide evidence that young women’s age-disparate partnerships involve greater sexual risk, particularly through the risky behaviours of their male partners, with the risk amplified for young women in urban areas.
Url:
DOI: 10.1371/journal.pone.0159162
PubMed: 27526116
PubMed Central: 4985138
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PMC:4985138Le document en format XML
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<author><name sortKey="Maughan Brown, Brendan" sort="Maughan Brown, Brendan" uniqKey="Maughan Brown B" first="Brendan" last="Maughan-Brown">Brendan Maughan-Brown</name>
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<author><name sortKey="Evans, Meredith" sort="Evans, Meredith" uniqKey="Evans M" first="Meredith" last="Evans">Meredith Evans</name>
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<author><name sortKey="George, Gavin" sort="George, Gavin" uniqKey="George G" first="Gavin" last="George">Gavin George</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Sexual Behaviour of Men and Women within Age-Disparate Partnerships in South Africa: Implications for Young Women's HIV Risk</title>
<author><name sortKey="Maughan Brown, Brendan" sort="Maughan Brown, Brendan" uniqKey="Maughan Brown B" first="Brendan" last="Maughan-Brown">Brendan Maughan-Brown</name>
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<author><name sortKey="Evans, Meredith" sort="Evans, Meredith" uniqKey="Evans M" first="Meredith" last="Evans">Meredith Evans</name>
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<author><name sortKey="George, Gavin" sort="George, Gavin" uniqKey="George G" first="Gavin" last="George">Gavin George</name>
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<series><title level="j">PLoS ONE</title>
<idno type="eISSN">1932-6203</idno>
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<front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Background</title>
<p>Age-disparate partnerships are hypothesized to increase HIV-risk for young women. However, the evidence base remains mixed. Most studies have focused only on unprotected sex among women in the partnership. Consequently, little is known about other risky behaviours, such as transactional sex, alcohol use, and concurrency, as well as the behaviours of the men who partner with young women. We therefore examined differences in various sexual behaviours of both young women and their male partners by partnership age difference.</p>
</sec>
<sec id="sec002"><title>Methods</title>
<p>We used nationally representative data from South Africa (2012) on partnerships reported by 16–24 year old black African women (n = 818) and by black African men in partnerships with 16–24 year old women (n = 985). We compared sexual behaviours in age-disparate partnerships and age-similar partnerships, using multiple logistic regression to control for potential confounders and to assess rural/urban differences.</p>
</sec>
<sec id="sec003"><title>Results</title>
<p>Young women in age-disparate partnerships were more likely to report unprotected sex than young women in similar-aged partnerships (aOR:1.51; p = 0.014; 95%CI:1.09–2.11). Men in partnerships with young women were more likely to report unprotected sex (aOR:1.92; p<0.01; 95%CI:1.31–2.81), transactional sex (aOR:2.73; p<0.01; 95%CI:1.64–4.56), drinking alcohol before sex (aOR:1.60; p = 0.062; 95%CI:0.98–2.61), and concurrency (aOR:1.39; p = 0.097; 95%CI:0.94–2.07) when their partners were five or more years younger. The association between age-disparate partnerships and transactional sex (aOR:4.14; p<0.01; 95%CI: 2.03–8.46) and alcohol use (aOR:2.24; p<0.013; 95%CI:1.20–4.19) was only found in urban areas.</p>
</sec>
<sec id="sec004"><title>Conclusions</title>
<p>Results provide evidence that young women’s age-disparate partnerships involve greater sexual risk, particularly through the risky behaviours of their male partners, with the risk amplified for young women in urban areas.</p>
</sec>
</div>
</front>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id>
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<article-meta><article-id pub-id-type="pmid">27526116</article-id>
<article-id pub-id-type="pmc">4985138</article-id>
<article-id pub-id-type="doi">10.1371/journal.pone.0159162</article-id>
<article-id pub-id-type="publisher-id">PONE-D-16-11640</article-id>
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<subj-group><subject>Human Sexual Behavior</subject>
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<subj-group><subject>Medical Microbiology</subject>
<subj-group><subject>Microbial Pathogens</subject>
<subj-group><subject>Viral Pathogens</subject>
<subj-group><subject>Immunodeficiency Viruses</subject>
<subj-group><subject>HIV</subject>
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<subj-group><subject>Viral Pathogens</subject>
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<subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject>
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<subj-group subj-group-type="Discipline-v3"><subject>Biology and life sciences</subject>
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<subj-group><subject>RNA viruses</subject>
<subj-group><subject>Retroviruses</subject>
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</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject>
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<subj-group><subject>Viral Pathogens</subject>
<subj-group><subject>Retroviruses</subject>
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<subj-group><subject>Behavioral Geography</subject>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Medicine and health sciences</subject>
<subj-group><subject>Infectious diseases</subject>
<subj-group><subject>Viral diseases</subject>
<subj-group><subject>HIV infections</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Earth Sciences</subject>
<subj-group><subject>Geography</subject>
<subj-group><subject>Geographic Areas</subject>
<subj-group><subject>Rural Areas</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>People and Places</subject>
<subj-group><subject>Population Groupings</subject>
<subj-group><subject>Ethnicities</subject>
<subj-group><subject>Africans</subject>
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<title-group><article-title>Sexual Behaviour of Men and Women within Age-Disparate Partnerships in South Africa: Implications for Young Women's HIV Risk</article-title>
<alt-title alt-title-type="running-head">Sexual Behaviour within Age-Disparate Partnerships</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Maughan-Brown</surname>
<given-names>Brendan</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
<xref ref-type="corresp" rid="cor001">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Evans</surname>
<given-names>Meredith</given-names>
</name>
<xref ref-type="aff" rid="aff002"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>George</surname>
<given-names>Gavin</given-names>
</name>
<xref ref-type="aff" rid="aff003"><sup>3</sup>
</xref>
</contrib>
</contrib-group>
<aff id="aff001"><label>1</label>
<addr-line>Southern Africa Labour and Development Research Unit (SALDRU), Department of Economics, University of Cape Town, Cape Town, South Africa</addr-line>
</aff>
<aff id="aff002"><label>2</label>
<addr-line>The Institute for Humanities in Africa (HUMA), Department of Sociology, University of Cape Town, Cape Town, South Africa</addr-line>
</aff>
<aff id="aff003"><label>3</label>
<addr-line>Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa</addr-line>
</aff>
<contrib-group><contrib contrib-type="editor"><name><surname>Seeley</surname>
<given-names>Janet</given-names>
</name>
<role>Editor</role>
<xref ref-type="aff" rid="edit1"></xref>
</contrib>
</contrib-group>
<aff id="edit1"><addr-line>London School of Hygiene and Tropical Medicine, UNITED KINGDOM</addr-line>
</aff>
<author-notes><fn fn-type="conflict" id="coi001"><p><bold>Competing Interests: </bold>
The authors have declared that no competing interests exist.</p>
</fn>
<fn fn-type="con"><p><list list-type="simple"><list-item><p><bold>Conceived and designed the experiments:</bold>
BMB ME GG.</p>
</list-item>
<list-item><p><bold>Analyzed the data:</bold>
BMB ME.</p>
</list-item>
<list-item><p><bold>Contributed reagents/materials/analysis tools:</bold>
BMB ME GG.</p>
</list-item>
<list-item><p><bold>Wrote the paper:</bold>
BMB ME GG.</p>
</list-item>
</list>
</p>
</fn>
<corresp id="cor001">* E-mail: <email>brendan.maughanbrown@gmail.com</email>
</corresp>
</author-notes>
<pub-date pub-type="epub"><day>15</day>
<month>8</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="collection"><year>2016</year>
</pub-date>
<volume>11</volume>
<issue>8</issue>
<elocation-id>e0159162</elocation-id>
<history><date date-type="received"><day>21</day>
<month>3</month>
<year>2016</year>
</date>
<date date-type="accepted"><day>28</day>
<month>6</month>
<year>2016</year>
</date>
</history>
<permissions><copyright-statement>© 2016 Maughan-Brown et al</copyright-statement>
<copyright-year>2016</copyright-year>
<copyright-holder>Maughan-Brown et al</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>
, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p>
</license>
</permissions>
<self-uri content-type="pdf" xlink:href="pone.0159162.pdf"></self-uri>
<abstract><sec id="sec001"><title>Background</title>
<p>Age-disparate partnerships are hypothesized to increase HIV-risk for young women. However, the evidence base remains mixed. Most studies have focused only on unprotected sex among women in the partnership. Consequently, little is known about other risky behaviours, such as transactional sex, alcohol use, and concurrency, as well as the behaviours of the men who partner with young women. We therefore examined differences in various sexual behaviours of both young women and their male partners by partnership age difference.</p>
</sec>
<sec id="sec002"><title>Methods</title>
<p>We used nationally representative data from South Africa (2012) on partnerships reported by 16–24 year old black African women (n = 818) and by black African men in partnerships with 16–24 year old women (n = 985). We compared sexual behaviours in age-disparate partnerships and age-similar partnerships, using multiple logistic regression to control for potential confounders and to assess rural/urban differences.</p>
</sec>
<sec id="sec003"><title>Results</title>
<p>Young women in age-disparate partnerships were more likely to report unprotected sex than young women in similar-aged partnerships (aOR:1.51; p = 0.014; 95%CI:1.09–2.11). Men in partnerships with young women were more likely to report unprotected sex (aOR:1.92; p<0.01; 95%CI:1.31–2.81), transactional sex (aOR:2.73; p<0.01; 95%CI:1.64–4.56), drinking alcohol before sex (aOR:1.60; p = 0.062; 95%CI:0.98–2.61), and concurrency (aOR:1.39; p = 0.097; 95%CI:0.94–2.07) when their partners were five or more years younger. The association between age-disparate partnerships and transactional sex (aOR:4.14; p<0.01; 95%CI: 2.03–8.46) and alcohol use (aOR:2.24; p<0.013; 95%CI:1.20–4.19) was only found in urban areas.</p>
</sec>
<sec id="sec004"><title>Conclusions</title>
<p>Results provide evidence that young women’s age-disparate partnerships involve greater sexual risk, particularly through the risky behaviours of their male partners, with the risk amplified for young women in urban areas.</p>
</sec>
</abstract>
<funding-group><funding-statement>Brendan Maughan-Brown acknowledges support from the National Research Foundation, South Africa, through the Research Career Advancement Fellowship. The National Research Foundation had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</funding-statement>
</funding-group>
<counts><fig-count count="2"></fig-count>
<table-count count="3"></table-count>
<page-count count="16"></page-count>
</counts>
<custom-meta-group><custom-meta id="data-availability"><meta-name>Data Availability</meta-name>
<meta-value>The National HIV Communication Survey (NCS), 2012 Steering Committee is the owner of the data used in our study. Researchers who wish to gain access to these data can contact Dr Saul Johnson (<email>saul.johnson@hda.co.za</email>
).</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
<notes><title>Data Availability</title>
<p>The National HIV Communication Survey (NCS), 2012 Steering Committee is the owner of the data used in our study. Researchers who wish to gain access to these data can contact Dr Saul Johnson (<email>saul.johnson@hda.co.za</email>
).</p>
</notes>
</front>
</pmc>
<affiliations><list><country><li>Afrique du Sud</li>
</country>
</list>
<tree><country name="Afrique du Sud"><noRegion><name sortKey="Maughan Brown, Brendan" sort="Maughan Brown, Brendan" uniqKey="Maughan Brown B" first="Brendan" last="Maughan-Brown">Brendan Maughan-Brown</name>
</noRegion>
<name sortKey="Evans, Meredith" sort="Evans, Meredith" uniqKey="Evans M" first="Meredith" last="Evans">Meredith Evans</name>
<name sortKey="George, Gavin" sort="George, Gavin" uniqKey="George G" first="Gavin" last="George">Gavin George</name>
</country>
</tree>
</affiliations>
</record>
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