Shisana, O., Risher, K., Celentano, D.D., et al. AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV (November 2015), 28(2):234-241, doi: 10.1080/09540121.2015.1080790.
The authors of this study analyzed findings from the 2012 South African National HIV Prevalence, Incidence and Behavior Survey to clarify the relationship between marital status and HIV in the South African population. Of 17,356 respondents aged 16 years or older who provided specimens for HIV testing, 5,930 (34.2%) were married and living together; 589 (3.4%) were married but living separately; 1,743 (10.0%) were cohabitating with their partner; 3,958 (22.8%) were in a steady relationship but not living with their partner; and 5,136 (29.6%) were single, divorced, or widowed. Analysis showed that individuals who were married and living together were significantly less likely to be HIV-positive compared to all other marital status groups. Being married and living apart was associated with significantly increased odds of being HIV-positive, compared to being married and living together. The highest HIV incidence rate was found in the cohabiting group: 10.8 times higher than the incidence among participants who were married and living together. The authors concluded that given declining marriage rates and poor economic conditions in South Africa, messages on prevention should target unmarried and cohabiting people, and communicate that living together while unmarried carries the highest risk among all marital statuses in South Africa.