Dataset Information

Effect of Quality of Caregiver-Adolescent Relationship on Sexual Debut, Transactional Sex, and on Age-Disparate Relationships Among Young Women in Rural South Africa Enrolled in HPTN 068.

ABSTRACT:

Background

Adolescent girls and young women (AGYW) remain burdened by the HIV epidemic. Positive caregiver-child relationships are associated with safe sexual behaviors in young people; yet, this literature often highlights the role of parent-child communication and parental monitoring, neglecting the importance of emotional relationships between a caregiver and adolescent.

Setting

We used longitudinal data from HIV Prevention Trial Network 068-conducted among 2533 AGYW (13-20 years) over a period of 5 years in Agincourt, South Africa.

Method

Kaplan-Meier and Cox models were used to estimate the effect of quality of caregiver-adolescent relationships (caring and closeness) on sexual debut, and log-binomial models with generalized estimating equations were used to examine the relationship between our exposures and transactional sex and age-disparate relationships.

Results

Sexual debut was delayed among those who reported high levels of caregiver caring [hazard ratio: 0.80, 95% confidence interval (CI): 0.69 to 0.93] and caregiver closeness (hazard ratio: 0.80, 95% CI: 0.68 to 0.95). AGYW who reported high quality caregiver-adolescent relationships had a lower risk of transactional sex [caring: risk ratio (RR): 0.67, 95% CI: 0.58 to 0.78; closeness: RR: 0.58; 95% CI: 0.50 to 0.67]. Similarly, those with high-quality caregiver-adolescent relationships were less likely to be in an age-disparate relationship (caring: RR: 0.68, 95% CI: 0.58 to 0.79; closeness: RR: 0.77, 95% CI: 0.66 to 0.90).

Conclusions

Findings indicate high-quality caregiver-adolescent relationships are associated with delayed sexual debut, a lower risk of transactional sex, and having an older partner. Family-centered interventions are needed to improve relationships between AGYW and caregivers.

SUBMITTER: Shangase N

PROVIDER: S-EPMC8887792 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

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Publications

Effect of Quality of Caregiver-Adolescent Relationship on Sexual Debut, Transactional Sex, and on Age-Disparate Relationships Among Young Women in Rural South Africa Enrolled in HPTN 068.

Shangase Nosipho N Edwards Jess J Pence Brian B Aiello Allison A Hussong Andrea A Gómez-Olivé Xavier X Kahn Kathleen K Stoner Marie M Pettifor Audrey A

Journal of acquired immune deficiency syndromes (1999) 20220401 4

<h4>Background</h4>Adolescent girls and young women (AGYW) remain burdened by the HIV epidemic. Positive caregiver-child relationships are associated with safe sexual behaviors in young people; yet, this literature often highlights the role of parent-child communication and parental monitoring, neglecting the importance of emotional relationships between a caregiver and adolescent.<h4>Setting</h4>We used longitudinal data from HIV Prevention Trial Network 068-conducted among 2533 AGYW (13-20 yea ...[more]

PMID: 35202045

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Project description:The aetiology of bacterial vaginosis (BV) is not well-understood, and prevalence appears to be higher among women living in sub-Saharan Africa. A recent conceptual model implicates three main bacteria (Gardnerella vaginalis; Atopobium vaginae; and Prevotella bivia), sexual activity, sialidase activity, and biofilm formation in the pathogenesis of BV. We describe the vaginal microbiota, presence of the putative sialidase A gene of G. vaginalis, and biofilm among 386 adolescent girls aged 17 and 18 years in a cross-sectional study in Mwanza, Tanzania around the time of expected sexual debut. Vaginal swabs were collected and tested by quantitative polymerase chain reaction (qPCR) for five Lactobacillus species, G. vaginalis, A. vaginae, P. bivia, the sialidase A gene of G. vaginalis, and by fluorescence in situ hybridisation (FISH) for evidence of G. vaginalis and A. vaginae biofilm. We conducted a risk factor analysis of G. vaginalis, A. vaginae and P. bivia, and explored the associations between biofilm, the presence of the sialidase A gene, and non-optimal vaginal microbiota (Nugent 4-7). L. crispatus and L. iners were detected in 69 and 82% of girls, respectively. The prevalence of L. crispatus was higher than previously reported in earlier studies among East and Southern African women. G. vaginalis, A. vaginae, P. bivia were independently associated with reported penile-vaginal sex. Samples with all three BV-associated bacteria made up the highest proportion of samples with Nugent-BV compared to samples with each bacterium alone or together in pairs. Of the 238 girls with G. vaginalis, 63% had the sialidase A gene detected, though there was no difference by reported sexual activity (p = 0.197). Of the 191 girls with results for sialidase A gene and FISH, there was strong evidence for an increased presence of sialidase A gene among those with evidence of a biofilm (p < 0.001). There was a strong association between biofilm and non-optimal microbiota (aOR67.00; 95% CI 26.72-190.53). These results support several of the steps outlined in the conceptual model, although the role of sexual activity is less clear. We recommend longitudinal studies to better understand changes in vaginal microbiota and biofilm formation around the time of sexual debut.

Dataset Information

Effect of Quality of Caregiver-Adolescent Relationship on Sexual Debut, Transactional Sex, and on Age-Disparate Relationships Among Young Women in Rural South Africa Enrolled in HPTN 068.

Background

Setting

Method

Results

Conclusions

Publications

Effect of Quality of Caregiver-Adolescent Relationship on Sexual Debut, Transactional Sex, and on Age-Disparate Relationships Among Young Women in Rural South Africa Enrolled in HPTN 068.

Similar Datasets

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