A community‐based study to examine the effect of a youth HIV prevention intervention on young people aged 15–24 in South Africa: results of the baseline survey

• Published in: Tropical medicine & international health 2005-10, Vol.10 (10), p.971-980
• Main Authors: Pettifor, Audrey E., Kleinschmidt, Immo, Levin, Jonathan, Rees, Helen V., MacPhail, Catherine, Madikizela‐Hlongwa, Lindiwe, Vermaak, Kerry, Napier, Grant, Stevens, Wendy, Padian, Nancy S.
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent Behavior - psychology; adolescents; Adult; AIDS-Related Opportunistic Infections - epidemiology; AIDS-Related Opportunistic Infections - prevention & control; Biological and medical sciences; Chlamydia Infections - epidemiology; Chlamydia Infections - prevention & control; Chlamydia trachomatis; Cross-Sectional Studies; evaluation studies; Female; Gonorrhea - epidemiology; Gonorrhea - prevention & control; Health Education - methods; HIV; HIV Infections - epidemiology; HIV Infections - prevention & control; HIV Infections - psychology; Human immunodeficiency virus; Human viral diseases; Humans; Infectious diseases; Intervention; Male; Medical sciences; Neisseria gonorrhoeae; Polls & surveys; Population Surveillance - methods; Prevalence; Prevention programs; Risk Factors; Risk-Taking; Sex Distribution; Sexual behavior; Sexual Behavior - psychology; sexual behaviour; Sexual Partners; Sexually Transmitted Diseases, Bacterial - epidemiology; Sexually Transmitted Diseases, Bacterial - prevention & control; sexually transmitted infections; South Africa; South Africa - epidemiology; Teenagers; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Young adults
• ISSN: 1360-2276; 1365-3156
• DOI: 10.1111/j.1365-3156.2005.01483.x

Summary Objectives  To determine whether South African youths living in communities that had either of two youth human immunodeficiency virus (HIV) prevention interventions [(a) loveLife Youth Centre or (b) loveLife National Adolescent Friendly Clinic Initiative] would have a lower prevalence of HIV, sexually transmitted infections (STIs), and high risk sexual behaviours than communities without either of these interventions. Methods  In 2002 the baseline survey of a quasi‐experimental, community‐based study was conducted in South Africa. In total 33 communities were included in three study arms (11 communities per study arm). The final sample included 8735 youths aged 15–24 years. All participants took part in a behavioural interview and were tested for HIV, gonorrhoea (Neisseria gonorrhoeae) and Chlamydia (Chlamydia trachomatis). Results  HIV prevalence was 20.0% among females and 7.5% among males (OR 3.93 95% CI 2.51–6.15). There were no significant differences between study arms for HIV, NG or CT prevalence at baseline. In multiple regression analyses, HIV was significantly associated with NG infection (OR 1.96 95% CI 1.24–3.12) but not with CT infection. Youths who reported >1 lifetime partner were also significantly more likely to be infected with HIV (OR 1.98 95% CI 1.55–2.52), as were those who reported ever having engaged in transactional sex (OR 1.86 P = 0.02) or having had genital ulcers in the past 12 months (OR 1.71 P ≤ 0.001). Conclusions  HIV prevention programmes must ensure that gender inequities that place young women at greater risk for HIV infection are urgently addressed and they must continue to emphasize the importance of reducing the number of sexual partners and STI treatment.