Community Space, Community Groups, and Incident HIV Infection among Adolescent Girls and Young Women in Rural South Africa: A Longitudinal Analysis of HIV Prevention Trials Network 068 Data

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Citation

Bhushan, Nivedita L.; Stoner, Marie C. D.; Twine, Rhian; Kahn, Kathleen; Lippman, Sheri A.; & Pettifor, Audrey E. (2021). Community Space, Community Groups, and Incident HIV Infection among Adolescent Girls and Young Women in Rural South Africa: A Longitudinal Analysis of HIV Prevention Trials Network 068 Data. Journal of Acquired Immune Deficiency Syndrome, 87(3), e207-13. PMCID: PMC8192416

Abstract

BACKGROUND: As adolescent girls and young women (AGYW) transition to adulthood, their interaction with their social context becomes a critical consideration for HIV prevention interventions. Few studies have examined what types of community groups and community spaces might be protective for AGYW HIV acquisition and related sexual behaviors.
METHODS: Data are from HIV Prevention Trials Network (HPTN) 068, a longitudinal study of AGYW (age 13-20) in rural South Africa. Survival analyses and generalized estimating equations were used to assess whether community group membership and time spent in community spaces were associated with HIV incidence and sexual behaviors (unprotected sex, transactional sex, and having an older partner).
RESULTS: A total of 2,245 AGYW were followed for up to four years. Membership in church groups (adjusted hazard ratio (aHR): 0.75, 95% CI: 0.53, 0.91), dance groups (aHR: 0.89, 95% CI; 0.80, 0.98), and spending time at church (aHR: 0.88, 95% CI: 0.79, 0.98) was protective for HIV infection. Conversely, spending time at taverns was associated with higher HIV incidence (aHR: 1.27, 95% CI: 1.15, 1.41). Membership in church groups and spending time at a family member's home and at church was protective for all three sexual behaviors. Spending time at a boyfriend's home and taverns was risky for all three sexual behaviors.
CONCLUSION: Results suggest that community spaces and community groups that include an element of adult supervision are potentially protective, while spaces and groups that provide an opportunity for AGYW to interact unsupervised with boyfriends or meet new partners are potentially risky.

URL

http://dx.doi.org/10.1097/qai.0000000000002676

Reference Type

Journal Article

Year Published

2021

Journal Title

Journal of Acquired Immune Deficiency Syndrome

Author(s)

Bhushan, Nivedita L.
Stoner, Marie C. D.
Twine, Rhian
Kahn, Kathleen
Lippman, Sheri A.
Pettifor, Audrey E.

Article Type

Regular

PMCID

PMC8192416

Data Set/Study

HIV Prevention Trials Network (HPTN)

Continent/Country

South Africa

Sex/Gender

Women

ORCiD

Pettifor - 0000-0002-3387-0817