Abdool Karim, Q., Kharsany, A., Leask, K., et al. Sexually Transmitted Infections (December 2014), doi: 10.1136/sextrans-2014-051548.
This cross-sectional biobehavioral study described the demographic and biological characteristics of high school students in rural South Africa. The study enrolled 1,423 females and 1,252 males from 14 high schools. All participants completed self-reported questionnaires and provided dried blood spot specimens for HIV and HSV-2 testing and urine specimens for pregnancy testing. The median age of coital debut for sexually experienced students was 15 years for boys and 16 years for girls, with boys reporting more experience than girls (33. 1 percent versus 21.6 percent). Boys were more likely than girls to have a sexual partner of their own age or younger. The prevalence of HIV was 1.4 percent in boys and 6.4 percent in girls, and a greater proportion of girls than boys were HIV-positive by age 18. HSV-2 prevalence was 2.6 percent in boys and 10.7 percent in girls, and increased rapidly in both from age 15. Risk factors associated with higher prevalence of HIV and HSV-2 among girls included being over age 18, previous pregnancy, and two or more deaths in the household over the previous year. The authors concluded that the high prevalence of HIV, HSV-2, and pregnancy among high school students indicates a need for school-based sexual and reproductive health services and the inclusion of adolescents in behavioral and biomedical HIV trials.