Factors Driving the HIV Epidemic in Southern Africa

Abstract

The HIV pandemic has disproportionately impacted sub-Saharan Africa and Southern Africa in particular. The concurrent presence of overlapping epidemic drivers likely underpins how and why the HIV epidemic is so explosive in this region, with implications for understanding approaches to reduce transmission. In this review, we discuss the relative contribution and interaction between epidemic drivers in the Southern African context, including factors both distally and proximally associated with the likelihood and degree of exposure to HIV and factors that increase the probability of transmission when exposure occurs. In particular, we focus on young women as a key population in need of HIV prevention and highlight factors that increase their risk on several levels.

Keywords: Adolescent mucosal immunology; Behavioral interventions; Conditional cash transfers; HIV; Phylogenetics; Sexually transmitted infections; Southern Africa; Structural risk factors; Transmission co-factors; Young women.