The role of age-mixing patterns in HIV transmission dynamics : Novel hypotheses from a field study in Cape Town, South Africa
Date
2018
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier
Abstract
Background: Age-disparate relationships are thought to put young women at increased risk of HIV, though
current evidence is inconclusive. Studying population-level age-mixing patterns as well as individual-level
measures of age difference variation may provide insight into the persistence and magnitude of the epidemic in
South Africa.
Methods: We used data from a survey in Cape Town (n=506) to describe age-mixing dynamics in the four
population strata of HIV negative and HIV positive male and female participants. Mixed-effects models were
used to calculate the average increase in partner age for each year increase in age of participant, the average
partner age for 15 year olds, and the between-subject and the within-subject standard deviation of partner ages.
We conducted 2000 bootstrap replications of the models. Using negative binomial models, we also explored
whether HIV status was associated with participants having a larger range in partner ages.
Results: HIV positive women had large variability in partner ages at the population level, and at the individual
level had nearly three times the expected range of partner ages compared to HIV negative women. This pattern
may increase the potential for HIV transmission across birth cohorts and may partially explain the persistence of
the epidemic in South Africa. Young men, who have been previously absent from the age-disparity discourse,
also choose older partners who may be putting them at increased risk of HIV infection due to the high HIV
prevalence among older age categories of women.
Description
CITATION: Beauclair, R., Hens, N. & Delva, W. 2018. The role of age-mixing patterns in HIV transmission dynamics : Novel hypotheses from a field study in Cape Town, South Africa. Epidemics, 25:61-71, doi:10.1016/j.epidem.2018.05.006.
The original publication is available at https://www.sciencedirect.com
The original publication is available at https://www.sciencedirect.com
Keywords
HIV infections -- Cape Town -- South Africa, HIV infected persons -- Sexual behavior, HIV infections -- Age factors
Citation
Beauclair, R., Hens, N. & Delva, W. 2018. The role of age-mixing patterns in HIV transmission dynamics : Novel hypotheses from a field study in Cape Town, South Africa. Epidemics, 25:61-71, doi:10.1016/j.epidem.2018.05.006