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[Preprint]. 2024 Sep 9:2024.09.08.24313251.
doi: 10.1101/2024.09.08.24313251.

eYoung men's experiences of violence and poverty and the relationship to sexually transmissible HIV: a cross sectional study from rural South Africa

Andrew Gibbs  1   2   3 , Esnat Chirwa  2 , Guy Harling  3   4 , Natsayi Chimbindi  3   5   4 , Jaco Dreyer  5 , Carina Herbst  5 , Nonhlanhla Okesola  5 , Osee Behuhuma  5 , Nondumiso Mthiyane  3   5 , Kathy Baisley  5   6 , Thembelihle Zuma  3   5   4 , Theresa Smit  5 , Nuala McGrath  5   7   4 , Lorraine Sherr  8 , Janet Seeley  5   6   4 , Maryam Shahmanesh  3   5   4
Affiliations

eYoung men's experiences of violence and poverty and the relationship to sexually transmissible HIV: a cross sectional study from rural South Africa

Andrew Gibbs et al. medRxiv. .

Update in

Abstract

Background: Young (ages 18-35 years) men are inadequately engaged in HIV prevention and treatment globally, including in South Africa, increasing the likelihood of them having sexually transmissible HIV (i.e. living with HIV but with high viral loads). We sought to understand how men's experiences of poverty and violence, impacted on transmissible HIV, directly or indirectly via mental health and substance misuse.

Setting: Rural communities in northern KwaZulu-Natal, South Africa.

Methods: Cross-sectional population-based random selection (September 2018-June 2019), assessing transmissible HIV (living with HIV and viral load ≥400 copies/mL) via dried blood spots, and socio-demographic data. Structural equation models (SEM), assessed direct and indirect pathways from food insecurity and violence experience to transmissible-HIV, with mediators common mental disorders, alcohol use, gender inequitable attitudes and perceptions of life chances.

Results: 2,086 young (ages 18-36 years) men and 8.6%(n=178) men had transmissible HIV. In SEM no direct pathways between food insecurity, or violence experience, and transmissible HIV. Poor mental health and alcohol use mediated the relationship between violence experience and food insecurity and transmissible HIV. Life chances also mediated the food insecurity to transmissible HIV pathway.

Conclusions: There was a high level of transmissible HIV in a representative sample of young men. The analysis highlights the need to address both the proximate 'drivers' poor mental health and substance misuse, as well as the social contexts shaping these among young men, namely poverty and violence experience. Building holistic interventions that adequately engage these multiple challenges is critical for improving HIV among young men.

Keywords: Gender; HIV/AIDS; Interpersonal Violence; Male; Mental Health; Poverty.

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Conflict of interest statement

Conflict of Interest Statement The authors have no conflict of interests to report.

Figures

Figure 1:
Figure 1:
Path model for transmissible HIV and mediated pathways
See this image and copyright information in PMC

References

    1. Colvin CJ. Strategies for engaging men in HIV services. The Lancet HIV. 2019; - PubMed
    1. Dovel K, Yeatman S, Watkins S, Poulin M. Men’s heightened risk of AIDS-related death: the legacy of gendered HIV testing and treatment strategies. AIDS (London, England). 2015;29(10):1123. - PMC - PubMed
    1. Grimsrud A, Ameyan W, Ayieko J, Shewchuk T. Shifting the narrative: from “the missing men” to “we are missing the men”. Journal of the International AIDS Society. 2020;23 Suppl 2(Suppl 2):e25526–e25526. doi: 10.1002/jia2.25526 - DOI - PMC - PubMed
    1. Cornell M, McIntyre J, Myer L. Men and antiretroviral therapy in Africa: our blind spot. Trop Med Int Health. 2011;16(7):828–829. - PMC - PubMed
    1. UNAIDS. Blind Spot: Reaching out to men and boys. 2017.

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