Do Age-Disparate Relationships Drive HIV Incidence in Young Women? Evidence from a Population Cohort in Rural KwaZulu-Natal, South Africa
Harling, G., Newell, M.L., Tanser, F., et al. Journal of Acquired Immune Deficiency Syndromes (August 2014), 66(4), pp. 443–51, doi:10.1097/QAI.0000000000000198..
Between January 2003 and June 2012 the authors studied 2,444 seronegative 15- to 29-year-old women in rural KwaZulu-Natal to determine whether the age disparity of women’s most recent sexual partner was associated with subsequent HIV acquisition. Each of the women was tested for HIV between two and eight times. During the study period, more than one-third of the young women had a partner five or more years older. The authors found no evidence that having an older male partner increased the risk of HIV infection in the young women. This finding was not influenced by the partner’s specific age or his age group, or the women's age, marital status, education, or household wealth. The authors hypothesized that this result may be due to young women in age-disparate relationships choosing less-risky partners than do young women in relationships with men of a similar age; and with older HIV-infected men being less infectious than younger men. The authors concluded that campaigns warning women about the risks of sexual partnerships with older men may reduce unwanted pregnancies or school dropout rates. However, they added that in the high-prevalence context of rural South Africa, these campaigns may not be a cost-effective way of using HIV-prevention resources.