Sexual practices among adolescents and young people in Eastern Cape, South Africa: the association with HIV status and mode of infection

Working paper number: 462
Author: Boladé Hamed Banougnin, Elona Toska,Yulia Shenderovich, Siyanai Zhou
Unit: CSSR


There is a growing cohort of adolescents living with HIV in Sub-Saharan Africa whom sexual and reproductive health (SRH) practices need to be investigated. We aimed at analysing the association of HIV status and mode of infection on SRH practices among adolescents in Eastern Cape, South Africa. We used data from a three-wave cohort of adolescents of the Mzantsi Wakho (MW) study carried out in 2014-15 (first wave), 2016-17 (second wave) and 2017-18 (third wave). The Mzantsi Wakho study included adolescents living with HIV and stigma community controls (i.e., adolescents not living with HIV). We fitted random-effects logistic regression models for risky sexual practice outcomes, such as unsafe sex, transactional sex, older partnership, multiple partnership, with the aforementioned risky sexual practice outcomes. These models were fit for all adolescents and the sub-sample of adolescents living with HIV. Findings from our analyses first revealed lower odds of reporting any risky sex (and especially unsafe sex) among HIV-positive adolescents than HIV-negative adolescents. Then, we found higher odds of reporting any risky sex (unsafe sex, older and multiple partnership) among horizontally infected adolescents than vertically infected adolescents. Finally, girls were more at risk than boys for the effect of HIV on risky sexual practices. Actions aimed at reducing risky sexual practices should target horizontally infected adolescents, and girls more specifically.

Publication file:BanougninToskaShenderovichZhou.pdf