Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2020 Aug 1;34(10):1539-1548.
doi: 10.1097/QAD.0000000000002582.

Risk of HIV infection among adolescent girls and young women in age-disparate relationships in sub-Saharan Africa

Francis Bajunirwe  1 , Daniel Semakula, Jonathan Izudi
Affiliations
Meta-Analysis

Risk of HIV infection among adolescent girls and young women in age-disparate relationships in sub-Saharan Africa

Francis Bajunirwe et al. AIDS. .

Abstract

Objective: To determine the association between age-disparate relationships and risk of HIV infection among adolescent girls and young women (AGYW) aged 15-24 years.

Design: Systematic review and meta-analysis of published studies until January 5, 2020 in sub Saharan Africa (SSA).

Methods: We searched several electronic databases, grey literature, and hand searched reference list of included studies to identify eligible studies for data abstraction. We assessed the quality of included studies using Newcastle-Ottawa Scale for nonrandomized studies. The DerSimonian-Laird random effects model was used to pool the overall results using risk ratios (RR), presented in a forest plot with 95% confidence interval (CI) and predictive interval. Heterogeneity was assessed with Cochrane's Q-test and quantified with I values. Publication bias was checked with funnel plots and Egger's test.

Results: We included 24 studies with an overall sample size of 33 390. Data show that age-disparate relationships were significantly associated with unprotected sexual intercourse (pooled RR, 1.57; 95% CI, 1.34-1.83; 95% predictive interval, 1.22-2.02), and higher risk for HIV infection (pooled RR, 1.39; 95 CI, 1.21-1.60; 95% predictive interval, 0.80-2.42). Studies included in pooling risk of unprotected sexual intercourse were largely homogeneous (I-value= 0.0, P = 0.79) whereas those for HIV infection were heterogeneous (I- value = 89.0%, P < 0.01). We found no publication bias and no study influenced the meta-analytic results.

Conclusion: Age-disparate relationships among AGYW are associated with increased risk of unprotected sexual intercourse and HIV infection in SSA. HIV prevention interventions should target this sub-population.

PubMed Disclaimer

References

    1. UNAIDS. Fact sheet - World AIDS Day 2019. Geneva, Switzerland: UNAIDS; 2020.
    1. UNAIDS. Get on the fast-track: the life-cycle approach to HIV: finding solutions for everyone at every stage of life. Geneva, Switzerland: UNAIDS; 2020.
    1. Idele P, Gillespie A, Porth T, Suzuki C, Mahy M, Kasedde S, et al. Epidemiology of HIV and AIDS among adolescents: current status, inequities, and data gaps. J Acquir Immune Defic Syndr 2014; 66:S144–S153.
    1. Dellar RC, Dlamini S, Karim QA. Adolescent girls and young women: key populations for HIV epidemic control. J Int AIDS Soc 2015; 18: (2 Suppl 1): 19408.
    1. Karim QA, Kharsany AB, Leask K, Ntombela F, Humphries H, Frohlich JA, et al. Prevalence of HIV, HSV-2 and pregnancy among high school students in rural KwaZulu-Natal, South Africa: a bio-behavioural cross-sectional survey. Sex Transm Infect 2014; 90:620–626.