Predictors of HIV, HIV Risk Perception, and HIV Worry among Adolescent Girls and Young Women in Lilongwe, Malawi

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Citation

Price, Joan T.; Rosenberg, Nora E.; Vansia, Dhrutika; Phanga, Twambilile; Bhushan, Nivedita L.; Maseko, Bertha; Brar, Savvy K.; Hosseinipour, Mina C.; Tang, Jennifer H.; & Bekker, Linda-Gail, et al. (2018). Predictors of HIV, HIV Risk Perception, and HIV Worry among Adolescent Girls and Young Women in Lilongwe, Malawi. Journal of Acquired Immune Deficiency Syndromes, 77(1), 53-63. PMCID: PMC5720919

Abstract

BACKGROUND: Adolescent girls and young women (AGYW) in sub-Saharan Africa have high HIV prevalence and incidence. We sought to understand which HIV risk factors individually and in combination contribute to risk, and whether these factors are associated with HIV worry and risk perception.
SETTING: This study is ongoing at four public health centers in Lilongwe, Malawi (2016-2017). METHODS: AGYW 15-24 years old were recruited to participate in a study assessing four models of service delivery. At each health center, participants completed a baseline survey assessing socio-economic, behavioral, biomedical and partnership characteristics; self-reported HIV status; and, if HIV-uninfected, HIV risk perception (high versus low or none) and HIV worry (any versus none). We analyzed associations between baseline characteristics and HIV prevalence, risk perception, and worry.
RESULTS: Among 1000 AGYW, median age was 19 years (IQR 17-21). Thirty-three participants reported being HIV-infected. Fifteen characteristics were associated with HIV infection. Having more risk factors was associated with higher HIV prevalence (8 factors, 21%). Having more risk factors was also associated with higher risk perception (p<0.001) and higher worry (p<0.001). However, among those with > 8 risk factors, 52% did not consider themselves to be at high risk and 21% did not report any HIV worry.
CONCLUSION: Most AGYW perceive little risk of HIV acquisition, even those at highest risk. As a critical gap in the HIV prevention cascade, accurate risk perception is needed to tailor effective and sustained combination prevention strategies for this vulnerable population.

URL

http://dx.doi.org/10.1097/QAI.0000000000001567

Reference Type

Journal Article

Year Published

2018

Journal Title

Journal of Acquired Immune Deficiency Syndromes

Author(s)

Price, Joan T.
Rosenberg, Nora E.
Vansia, Dhrutika
Phanga, Twambilile
Bhushan, Nivedita L.
Maseko, Bertha
Brar, Savvy K.
Hosseinipour, Mina C.
Tang, Jennifer H.
Bekker, Linda-Gail
Pettifor, Audrey E.

PMCID

PMC5720919

ORCiD

Pettifor - 0000-0002-3387-0817