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ABSTRACT: Background
Sexual partners are the primary source of incident HIV infection among adolescent girls and young women (AGYW) in sub-Saharan Africa. Identifying partner types at greatest risk of HIV transmission could guide the design of tailored HIV prevention interventions.Methods
We conducted a secondary analysis of data from AGYW (aged 13-23 years) enrolled in a randomized controlled trial of cash transfers for HIV prevention in South Africa. Annually, AGYW reported behavioral and demographic characteristics of their 3 most recent sexual partners, categorized each partner using prespecified labels, and received HIV testing. We used latent class analysis (LCA) to identify partner types from reported characteristics, and generalized estimating equations to estimate the relationship between both LCA-identified and prespecified partner types and incident HIV infection.Results
Across 2140 AGYW visits, 1034 AGYW made 2968 partner reports and 63 AGYW acquired HIV infection. We identified 5 LCA partner types, which we named monogamous HIV-negative peer partner; one-time protected in-school peer partner; out-of-school older partner; anonymous out-of-school peer partner; and cohabiting with children in-school peer partner. Compared to AGYW with only monogamous HIV-negative peer partners, AGYW with out-of-school older partners had 2.56 times the annual risk of HIV infection (95% confidence interval: 1.23 to 5.33), whereas AGYW with anonymous out-of-school peer partners had 1.72 times the risk (95% confidence interval: 0.82 to 3.59). Prespecified partner types were not associated with incident HIV.Conclusion
By identifying meaningful combinations of partner characteristics and predicting the corresponding risk of HIV acquisition among AGYW, LCA-identified partner types may provide new insights for the design of tailored HIV prevention interventions.
SUBMITTER: Nguyen N
PROVIDER: S-EPMC6692200 | biostudies-literature | 2019 Sep
REPOSITORIES: biostudies-literature
Nguyen Nadia N Powers Kimberly A KA Miller William C WC Howard Annie Green AG Halpern Carolyn T CT Hughes James P JP Wang Jing J Twine Rhian R Gomez-Olive F Xavier FX MacPhail Catherine C Kahn Kathleen K Pettifor Audrey E AE
Journal of acquired immune deficiency syndromes (1999) 20190901 1
<h4>Background</h4>Sexual partners are the primary source of incident HIV infection among adolescent girls and young women (AGYW) in sub-Saharan Africa. Identifying partner types at greatest risk of HIV transmission could guide the design of tailored HIV prevention interventions.<h4>Methods</h4>We conducted a secondary analysis of data from AGYW (aged 13-23 years) enrolled in a randomized controlled trial of cash transfers for HIV prevention in South Africa. Annually, AGYW reported behavioral an ...[more]