Sexual Behaviors and HIV Status: A Population-Based Study Among Older Adults in Rural South Africa

Autor: Molly Rosenberg, Chodziwadziwa W. Kabudula, Ryan G. Wagner, Stephen Tollman, Lisa F. Berkman, Brian Houle, Francesc Xavier Gómez-Olivé, Till Bärnighausen, Kathleen Kahn, Julia Rohr, Joshua A. Salomon
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Gerontology
Male
Rural Population
Casual
Epidemiology
HIV Infections
law.invention
South Africa
0302 clinical medicine
5. Gender equality
law
Risk Factors
Prevalence
Medicine
Pharmacology (medical)
030212 general & internal medicine
older adults
aging population
education.field_of_study
1. No poverty
Age Factors
virus diseases
Public Health
Global Health
Social Medicine and Epidemiology
Middle Aged
3. Good health
Infectious Diseases
Sexual behavior
ComputingMethodologies_DOCUMENTANDTEXTPROCESSING
Female
HIV transmission risk
0305 other medical science
Adult
Population ageing
Sexual Behavior
Population
03 medical and health sciences
sexual behavior
Sex Factors
Condom
Humans
education
Aged
030505 public health
business.industry
HIV acquisition risk
Confidence interval
Population based study
Folkhälsovetenskap
global hälsa
socialmedicin och epidemiologi
Hiv status
business
HIV transmission sk
Demography
Zdroj: Journal of Acquired Immune Deficiency Syndromes (1999)
ISSN: 1944-7884
1525-4135
Popis: Supplemental Digital Content is Available in the Text.
Objective: To identify the unmet needs for HIV prevention among older adults in rural South Africa. Methods: We analyzed data from a population-based sample of 5059 men and women aged 40 years and older from the study Health and Aging in Africa: Longitudinal Studies of INDEPTH Communities (HAALSI), which was carried out in the Agincourt health and sociodemographic surveillance system in the Mpumalanga province of South Africa. We estimated the prevalence of HIV (laboratory-confirmed and self-reported) and key sexual behaviors by age and sex. We compared sexual behavior profiles across HIV status categories with and without age–sex standardization. Results: HIV prevalence was very high among HAALSI participants (23%, 95% confidence interval [CI]: 21 to 24), with no sex differences. Recent sexual activity was common (56%, 95% CI: 55 to 58) across all HIV status categories. Condom use was low among HIV-negative adults (15%, 95% CI: 14 to 17), higher among HIV-positive adults who were unaware of their HIV status (27%, 95% CI: 22 to 33), and dramatically higher among HIV-positive adults who were aware of their status (75%, 95% CI: 70 to 80). Casual sex and multiple partnerships were reported at moderate levels, with slightly higher estimates among HIV-positive compared to HIV-negative adults. Differences by HIV status remained after age–sex standardization. Conclusions: Older HIV-positive adults in an HIV hyperendemic community of rural South Africa report sexual behaviors consistent with high HIV transmission risk. Older HIV-negative adults report sexual behaviors consistent with high HIV acquisition risk. Prevention initiatives tailored to the particular prevention needs of older adults are urgently needed to reduce HIV risk in this and similar communities in sub-Saharan Africa.
Databáze: OpenAIRE
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