Harling, G., Newell, M-L., Tanser, F., and Bärnighausen, T. AIDS and Behavior (July 2015), 19(7): 1317–1326.
The authors examined the association between partner age disparity and HIV acquisition among older women through a quantitative analysis of a population-based, open cohort of 1,734 women aged 30 years or older in a rural community in KwaZulu-Natal, South Africa between January 2003 and June 2012. Each woman was tested for HIV between two and nine times during the study period. When they compared women with same-age partners to women with partners five years older, the authors found that having an older partner reduced the risk of HIV acquisition by one-third. Having a partner who was 10 years older reduced the risk by half. The authors also noted that while overall, women's sociodemographic status did not significantly affect the association between age disparity and HIV acquisition risk, those with higher levels of education had the strongest decline in risk as the age disparity increased. More educated women also had the smallest average age disparity in their relationships and the lowest risk of HIV infection among those with partners of similar age. The authors concluded that the sexual behaviors of middle-aged individuals differ from those of younger groups, adding that campaigns that warn young women about older partners and HIV risk may not be appropriate for older women. They called for HIV prevention interventions specifically targeting older women.