Browsing by Author "Audrey E. Pettifor"

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    Friendships Among Young South African Women, Sexual Behaviours and Connections to Sexual Partners (HPTN 068)
    (2019-01-25) Elizabeth Fearon; Richard D. Wiggins; Audrey E. Pettifor; Catherine MacPhail; Kathleen Kahn; Amanda Selin; F. Xavier Gómez-Olivé; James R. Hargreaves
    Friends could be influential on young women’s sexual health via influences on sexual behaviours and as connections to sexual partners, but are understudied in sub-Saharan Africa. We crosssectionally surveyed 2326 13–20 year-old young women eligible for grades 8–11 in rural South Africa about their sexual behaviour and up to three sexual partners. Participants each described five specific but unidentified friends and the relationships between them in an ‘egocentric’ network analysis design. We used logistic regression to investigate associations between friendship characteristics and participants’ reports of ever having had sex (n=2326) and recent condom use (n=457). We used linear regression with random effects by participant to investigate friendship characteristics and age differences with sexual partners (n=633 participants, 1051 partners). We found that it was common for friends to introduce young women to those who later became sexual partners, and having older friends was associated with having older sexual partners, (increase of 0.37 years per friend at least one year older, 95% CI 0.21–0.52, adjusted). Young women were more likely to report ever having had sex when more friends were perceived to be sexually active (adjusted OR 1.85, 95% CI 1.72–2.01 per friend) and when they discussed sex, condoms and HIV with friends. Perception of friends’ condom use was not associated with participants’ reported condom use. While this study is preliminary and unique in this population and further research should be conducted, social connections between friends and sexual partners and perceptions of friend sexual behaviours could be considered in the design of sexual health interventions for young women in South Africa
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    Partnership Dynamics and HIV-Related Sexual Behaviors Among Adolescent Mothers in South Africa: A Longitudinal Analysis of HIV Prevention Trials Network 068 Data
    (2022-07) Nivedita L. Bhushan; Marie C.D. Stoner; Allison K. Groves; Kathleen Kahn; Audrey E. Pettifor
    Purpose: In South Africa, adolescent mothers have a three times higher risk of HIV acquisition than nonadolescent mothers. Yet, limited evidence exists regarding how early childbearing may affect HIV risk. A better understanding of adolescent mothers' partnership dynamics and sexual behaviors is critical to tailoring interventions to prevent new infections. Methods: Data are from HIV Prevention Trials Network 068, a longitudinal study of adolescent girls and young women (AGYW) aged 13-20 in South Africa who were followed annually for up to 6 years. Log-binomial regression models were used to assess whether adolescent motherhood was associated with partnership dynamics (intimate partner violence, gender inequitable norms, low relationship power, no HIV prevention communication) and if the association between partnership dynamics and sexual behaviors (unprotected sex and transactional sex) varied by adolescent motherhood. Generalized estimating equations, with an exchangeable correlation structure, were used to account for nonindependence. Results: Adolescent mothers were more likely than nonadolescent mothers to be in partnerships characterized by intimate partner violence, low relationship power, gender inequitable norms, and no HIV prevention communication. A higher proportion were also more likely to experience these dynamics, as well as engage in transactional sex, after giving birth. Poor partnership dynamics put AGYW at a higher risk for unprotected sex and transactional sex, regardless of adolescent motherhood status. Discussion: Engaging adolescent mothers in interventions post birth and developing interventions that address power imbalances in AGYW's sexual partnerships have the potential to reduce engagement in HIV-related sexual behaviors and HIV risk in the long term.