Characteristics of Age-Discordant Partnerships Associated With HIV Risk Among Young South African Women (HPTN 068).
Characteristics of Age-Discordant Partnerships Associated With HIV Risk Among Young South African Women (HPTN 068).
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DOI：
10.1097/qai.0000000000000988
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发表时间：
2016-08-01
期刊：
影响因子：
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通讯作者：
Pettifor A
中科院分区：
文献类型：
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作者：
Ritchwood TD;Hughes JP;Jennings L;MacPhail C;Williamson B;Selin A;Kahn K;Gómez-Olivé FX;Pettifor A
老年男子和年轻妇女之间的性关系与感染艾滋病毒的更大风险有关。本研究旨在：1）确定与年龄不一致（伴侣年龄≥ 5岁）和年龄一致伴侣关系（-1 <伴侣< 5岁）相关的心理社会和行为因素; 2）检查伴侣年龄不一致与年轻南非女性性行为之间的关联。我们使用广义估计方程来分析来自普马兰加省农村的656名有性经验的女性（年龄在13-20岁之间）的反应。伴侣年龄不一致与报告更频繁的性行为（调整后的比值比[aOR] = 1.77，95% CI 1.20-2.60）和伴侣同时存在伴侣关系（aOR = 1.77，95% CI 1.22-2.57）的几率更大相关。不和谐的伴侣关系与以下更大的几率相关：偶然的伴侣关系（aOR 1.50，95% CI 1.06-2.13），有一个同时存在伴侣关系的伴侣（aOR 1.71，95% CI 1.19-2.46）和更频繁的性交（即，每月至少有2或3次性生活）（aOR 2.04，95%CI 1.39-3.00）。在年龄不一致的伴侣关系中，他们与最后一次性行为时报告使用避孕套的几率较低（aOR 0.70，95%CI 0.50-0.98）和总是使用避孕套（aOR 0.53，95%CI 0.32-0.88）相关。我们的研究结果表明，年龄不一致的伙伴关系的历史，并在较小程度上有一个年龄不一致的合作伙伴，与艾滋病毒的风险在年轻的南非妇女，然而，合作伙伴年龄不一致和艾滋病毒的风险之间的联系可能更密切相关的年龄不一致的伙伴关系的特点，而不是形成这种伙伴关系的年轻妇女的特点。
Sexual liaisons between older men and younger women have been linked to greater risk of HIV acquisition. This study aims to: 1) identify psychosocial and behavioral factors associated with age-discordant (partner ≥ 5 years older) versus age-concordant partnerships (−1<partner< 5); and 2) examine the association between partner age discordance and young South African women's sexual behavior. We used generalized estimating equations to analyze responses from 656 sexually-experienced females (aged 13-20 years) from rural Mpumalanga province. Partner age discordance was associated with greater odds of reporting both more frequent sex (adjusted odd ratio [aOR] = 1.77, 95% CI 1.20-2.60) and having a partner with concurrent partnerships (aOR = 1.77, 95% CI 1.22-2.57). Age-discordant partnerships were associated with greater odds of: casual partnerships (aOR 1.50, 95% CI 1.06-2.13), having a partner with concurrent partnerships (aOR 1.71, 95% CI 1.19-2.46) and more frequent intercourse (i.e., having sex at least 2 or 3 times per month) (aOR 2.04, 95% CI 1.39-3.00). They were associated with lower odds of reporting condom use at last sex (aOR 0.70, 95% CI 0.50-0.98) and always using condoms (aOR 0.53, 95% CI 0.32-0.88) in age-discordant partnerships. Our findings suggest that a history of age-discordant partnerships, and to a lesser extent having an age-discordant partner, is linked to HIV risk among young South African women; however, the link between partner age discordance and HIV risk may be more strongly related to the characteristics of age-discordant partnerships than to characteristics of young women who form such partnerships.