Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, KwaZulu-Natal, South Africa.
Southern Africa Labour and Development Research Unit, University of Cape Town, Cape Town, South Africa.
BMJ Open. 2019 Mar 9;9(3):e024362. doi: 10.1136/bmjopen-2018-024362.
This study examines the role of age-disparate partnerships on young women's HIV risk by investigating coital frequency and condom use within age-disparate partnerships involving women aged 15 to 24.
A community-based, cross-sectional study was conducted.
Participants were randomly selected using a two-stage random sampling method in uMgungundlovu district, KwaZulu-Natal, South Africa, between June 2014 and June 2015.
A total of 1306 15-24-year-old women in an ongoing heterosexual partnership were included in the analysis. Participants had to be a resident in the area for 12 months, and able to provide informed consent and speak one of the local languages (Zulu or English).
Sexual frequency was assessed by asking participants how many times they had sex with each partner in the past 12 months. The degree of condomless sex within partnerships was assessed in the survey by asking participants how often they used a condom with their partners.
Age-disparate partnerships were associated with a higher order category (once, 2-5, 6-10, 11-20, >20) of coital frequency (adjusted OR (aOR) 1.32, p<0.05, 95% CI 1.02 to 1.71) and with sex on more than 10 occasions (aOR 1.48, p<0.01, 95% CI 1.12 to 1.96) compared with age-similar partnerships. Age-disparate partnerships were also more likely to involve sex on more than 10 occasions with inconsistent condom use (aOR 1.43, p<0.05, 95% CI 1.04 to 1.96) in the previous 12 months.
The finding that increased sexual activity is positively associated with age-disparate partnerships adds to the evidence that age-disparate partnerships pose greater HIV risk for young women. Our study results indicate that interventions to reduce risky sexual behaviour within age-disparate partnerships remain relevant to reducing the high HIV incidence rates among adolescent girls and young women.
本研究通过调查 15 至 24 岁女性的年龄差异伴侣关系中的性行为频率和 condom 使用情况，研究年龄差异伴侣关系对年轻女性 HIV 风险的影响。
本研究采用社区为基础的横断面研究方法。
参与者是在 2014 年 6 月至 2015 年 6 月期间，在夸祖鲁-纳塔尔省姆古温多洛区通过两阶段随机抽样方法随机选择的。
本研究共纳入了 1306 名处于异性恋关系中的 15-24 岁女性。参与者必须在该地区居住 12 个月，并且能够提供知情同意并会说当地语言（祖鲁语或英语）之一。
通过询问参与者在过去 12 个月中与每个伴侣发生性行为的次数来评估性行为频率。通过询问参与者与伴侣发生性行为时使用 condom 的频率，在调查中评估了伴侣关系中无 condom 性行为的程度。
年龄差异伴侣关系与更高的性行为频率类别（一次、2-5 次、6-10 次、11-20 次、>20 次）（调整后的比值比（aOR）为 1.32，p<0.05，95%置信区间（CI）为 1.02 至 1.71）和 10 次以上的性行为（aOR 为 1.48，p<0.01，95%CI 为 1.12 至 1.96）相关，与年龄相似的伴侣关系相比。年龄差异伴侣关系也更有可能在过去 12 个月中涉及 10 次以上的性行为和 condom 使用不一致（aOR 为 1.43，p<0.05，95%CI 为 1.04 至 1.96）。
性行为频率增加与年龄差异伴侣关系呈正相关的发现，进一步证明年龄差异伴侣关系给年轻女性带来了更大的 HIV 风险。我们的研究结果表明，减少年龄差异伴侣关系中危险性行为的干预措施仍然与降低青少年女孩和年轻女性的高 HIV 发病率有关。
