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. 2018 Nov;30(11):1435-1443.
doi: 10.1080/09540121.2018.1468008. Epub 2018 Apr 27.

Sexual behavior and HIV risk across the life course in rural South Africa: trends and comparisons

Brian Houle  1   2   3 , Sanyu A Mojola  4   5 , Nicole Angotti  2   3   6 , Enid Schatz  2   3   7 , F Xavier Gómez-Olivé  2   8 , Samuel J Clark  2   3   8   9   10 , Jill R Williams  2   3 , Chodziwadziwa Kabudula  2   8 , Stephen Tollman  2   8   11 , Jane Menken  2   3
Affiliations

Sexual behavior and HIV risk across the life course in rural South Africa: trends and comparisons

Brian Houle et al. AIDS Care. 2018 Nov.

Abstract

There is limited information about sexual behavior among older Africans, which is problematic given high HIV rates among older adults. We use a population-based survey among people aged 15-80+ to examine the prevalence of sexual risk and protective behaviors in the context of a severe HIV epidemic. We focus on variation across the life course, gender and HIV serostatus to compare the similarities and differences of young, middle aged, and older adults. Younger adults continue to be at risk of HIV, with potential partners being more likely to have been diagnosed with an STI and more likely to have HIV, partner change is high, and condom use is low. Middle aged and older adults engage in sexual behavior that makes them vulnerable at older ages, including extramarital sex, low condom use, and cross-generational sex with people in age groups with the highest rates of HIV. We find insignificant differences between HIV positive and negative adults' reports of recent sexual activity. This study provides new information on sexual behavior and HIV risk across the life course in rural South Africa to inform HIV prevention and treatment programing.

Keywords: HIV/AIDS; Sexual behavior; South Africa; life course.

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Figures

Figure 1:
Figure 1:
HIV prevalence (and 95% confidence intervals) in rural South Africa, 2010, by sex and age.
Figure 2:
Figure 2:
Prevalence of sexual behaviors (and 95% confidence intervals), by respondent sex and age. For extramarital partnerships, prevalence estimates include any casual, anonymous, or girlfriend/boyfriend partners reported in the past 2 years among married respondents (some estimates omitted due to small sample sizes).
Figure 3.
Figure 3.
Prevalence of sexual behaviors (and 95% confidence intervals), by respondent sex, age and HIV status. For extramarital partnerships, prevalence estimates include any casual, anonymous, or girlfriend/boyfriend partners reported in the past 2 years among married respondents (some estimates omitted due to small sample sizes).
Figure 4.
Figure 4.
Stacked bar chart of partner (most recent in past 2 years) age differences by respondent sex and age.
See this image and copyright information in PMC

References

    1. Castel AD, Befus M, Willis S, Griffin A, West T, Hader S, & Greenberg AE (2012). Use of the community viral load as a population-based biomarker of HIV burden. Aids, 26(3), pp. 345–353. - PubMed
    1. Clark S (2004). Early marriage and HIV risks in sub‐Saharan Africa. Studies in family planning, 35(3), pp. 149–160. - PubMed
    1. Clark S, & Brauner-Otto S (2015). Divorce in sub-Saharan Africa: are unions becoming less stable? Population and development review, 41(4), pp. 583–605.
    1. Clark S, Collinson MA, Kahn K, Drulinger K, & Tollman S (2007). Returning home to die: circular labor migration and mortality in South Africa. Scandinavian Journal of Public Health, 35(69), pp. 35–44. - PMC - PubMed
    1. Collinson MA (2010). Stiving against adversity: the dynamics of migration, health and poverty in rural South Africa. Global Health Action, 3, p 10.3402/gha.v3403i3400.5080. - PMC - PubMed

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