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Comparative Study
. 2011 Sep;49(3):237-243.e1.
doi: 10.1016/j.jadohealth.2010.10.002. Epub 2011 Mar 23.

A tale of two countries: rethinking sexual risk for HIV among young people in South Africa and the United States

Audrey E Pettifor  1 , Brooke A Levandowski, Catherine Macphail, William C Miller, Joyce Tabor, Carol Ford, Cheryl R Stein, Helen Rees, Myron Cohen
Affiliations
Comparative Study

A tale of two countries: rethinking sexual risk for HIV among young people in South Africa and the United States

Audrey E Pettifor et al. J Adolesc Health. 2011 Sep.

Abstract

Purpose: To compare the sexual behaviors of young people in South Africa (SA) and the United States (US) with the aim to better understand the potential role of sexual behavior in HIV transmission in these two countries that have strikingly different HIV epidemics.

Methods: Nationally representative, population-based surveys of young people aged 18-24 years from SA (n = 7,548) and the US (n = 13,451) were used for the present study.

Results: The prevalence of HIV was 10.2% in SA and <1% in the US. Young women and men in the US reported an earlier age of first sex than those in SA (mean age of coital debut for women: US [16.5], SA [17.4]; for men: US [16.4], SA [16.7]). The median number of lifetime partners is higher in the US than in SA: women: US (4), SA (2); men: US (4), SA (3). The use of condom at last sex is reported to be lower in the US than in SA: women: US (36.1%), SA (45.4%); men: US (48%), SA (58%). On average, young women in SA report greater age differences with their sex partners than young women in the US.

Conclusion: Young people in the US report riskier sexual behaviors than young people in SA, despite the much higher prevalence of HIV infection in SA. Factors above and beyond sexual behavior likely play a key role in the ongoing transmission of HIV in South African youth, and thus should be urgently uncovered to develop maximally effective prevention strategies.

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Figures

Figure 1
Figure 1
Age of first sex for young women and young men ages 18 to 24 years in South Africa (SA) and the United States (US).
Figure 2
Figure 2
Number of lifetime sexual partners for sexually experienced young women and young men ages 18 to 24 years in South Africa (SA) and the United States (US)
Figure 3
Figure 3
Age difference with most recent partner for young women and young men ages 18 to 24 years in South Africa (SA) and the United States (US)
See this image and copyright information in PMC

Comment in

References

Sources

    1. U.S. Department of Education. National Center for Education Statistics Digest of Education Statistics, 2005. 2006 (NCES 2006-030), Chapter 1.
    1. U.S. Department of Education. National Center for Education Statistics The Condition of Education 2007. 2007 (NCES 2007-064), Indicator 23.

References

    1. Pettifor A, Rees H, Kleinschmidt I, et al. Young people's sexual health in South Africa: HIV prevalence and sexual behaviours from a nationally representative household survey. AIDS. 2005;19:1525–1534. - PubMed
    1. Morris M, Handcock MS, Miller WC, et al. Prevalence of HIV Infection Among Young Adults in the United States: Results From the Add Health Study. Am J Public Health. 2006 Jun;96(6):1091–1097. - PMC - PubMed
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