Govender Kaymarlin, Beckett Sean, Mukuku Olivier, Cawood Cherie, George Gavin, Khanyile David, Reddy Tarylee, Cowden Richard, Puren Adrian
Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa.
Institut Supérieur des Techniques Médicales de Lubumbashi, Lubumbashi, Lubumbashi, Democratic Republic of Congo.
Front Public Health. 2025 Aug 26;13:1620084. doi: 10.3389/fpubh.2025.1620084. eCollection 2025.
High HIV prevalence among adolescent girls and young women (AGYW) in South Africa is driven by multiple interacting psychosocial risks. Some of these risks include socioeconomic deprivation, poor educational outcomes, poor mental health, alcohol and drug use which are associated with HIV-infection and sexual risk behavior. This article seeks to deepen our understanding of the role of psychosocial and behavioral factors in the HIV epidemic among AGYW.
A cross-sectional survey ( = 18,296) targeting AGYW aged between 12 and 24 years old was undertaken in four districts in KwaZulu-Natal and Gauteng. The analysis used descriptive statistics and hierarchical multiple binary logistic regressions that were disaggregated by age.
The mean age is 18 (SD:4) years old. Displaying depressive symptoms had increased odds of being HIV positive among the 15-19-year-old age group of AGYW (AOR: 1.12, 95% CI: 1.05-1.18, < 0.001). For the 20-24-year olds, increased substance use was associated with a higher likelihood of being HIV positive (AOR: 1.10, 95% CI: 1.03-1.17, < 0.01) and those who experienced Intimate Partner Violence (IPV) were more likely to be HIV positive (AOR: 1.41, 95% CI: 1.08-1.85, < 0.05). Our findings indicate a lower prevalence of depressive symptoms in the two adolescent groups (12-15 years old and 15-19 years old) than in the older group (20-24 years old); nevertheless, depressive symptoms increased the likelihood of being HIV positive.
This study suggests that HIV interventions are likely to be beneficial if they address individual HIV risk factors such as poor mental health challenges and IPV. However, due to the cross-sectional design, causality or temporal sequencing-particularly in bidirectional relationships such as depression and HIV-cannot be established. Interpretations should therefore be made with caution.
南非少女和年轻女性（AGYW）中艾滋病毒高流行率是由多种相互作用的社会心理风险驱动的。其中一些风险包括社会经济贫困、教育成果不佳、心理健康状况差、酗酒和吸毒，这些都与艾滋病毒感染和性风险行为有关。本文旨在加深我们对社会心理和行为因素在AGYW艾滋病毒流行中所起作用的理解。
在夸祖鲁 - 纳塔尔省和豪登省的四个地区对12至24岁的AGYW进行了一项横断面调查（n = 18296）。分析采用描述性统计和分层多元二元逻辑回归，并按年龄进行分类。
平均年龄为18岁（标准差：4）。在15至19岁的AGYW年龄组中，出现抑郁症状会增加艾滋病毒呈阳性的几率（调整后比值比：1.12，95%置信区间：1.05 - 1.18，P < 0.001）。对于20至24岁的人群，物质使用增加与艾滋病毒呈阳性的可能性更高有关（调整后比值比：1.10，95%置信区间：1.03 - 1.17，P < 0.01），而经历过亲密伴侣暴力（IPV）的人更有可能艾滋病毒呈阳性（调整后比值比：1.41，95%置信区间：1.08 - 1.85，P < 0.05）。我们的研究结果表明，两个青少年组（12至15岁和15至19岁）的抑郁症状患病率低于年龄较大的组（20至24岁）；然而，抑郁症状会增加艾滋病毒呈阳性的可能性。
本研究表明，如果艾滋病毒干预措施能够解决个体艾滋病毒风险因素，如心理健康挑战和亲密伴侣暴力等，可能会有益处。然而，由于采用的是横断面设计，无法确定因果关系或时间顺序——特别是在抑郁症和艾滋病毒等双向关系中。因此，解释时应谨慎。
