This study assesses whether men’s ART use mitigates HIV-risk within age-disparate partnerships. Using data from the 2012 South African National HIV survey, we analyzed differences in HIV prevalence and ART use between men in age-disparate and age-similar partnerships with young women aged 15–29 using multiple logistic regression analyses. Within partnerships involving women 15–24 years old, men in age-disparate partnerships were more likely to be HIV-positive (5–9 year age-gap: aOR 2.8, 95%CI 1.4–5.2; p < 0.01; 10+ year age-gap: aOR 2.2, 95%CI 1.0–4.6; p < 0.05). Men in age-disparate partnerships who were 5–9 years older were significantly more likely to be HIV-positive and ART-naïve (aOR 2.4, 95%CI 1.2–4.8; p < 0.05), while this was not the case for men 10+ years older (aOR 1.5, 95%CI 0.7–3.6; p = 0.32). No evidence was found that 25–29 year old women were at greater HIV-risk in age-disparate partnerships. Our results indicate that young women aged 15–24 have a greater likelihood of exposure to HIV through age-disparate partnerships, but ART use among men 10+ years older could mitigate risk.
HIV South Africa Sexual behaviour Age-disparate partnerships Intergenerational partnerships
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The authors acknowledge the dedication of fieldworkers and research staff of the Human Sciences Research Council and partners, as well as through the contributions of study participants, who made the 2012 South African National HIV Survey possible. The authors thank Atheendar Venkataramani and David Maughan Brown for helpful comments and suggestions on previous versions of this manuscript.
This study is based on data collected as part of the 2012 South African National HIV Survey, supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC) under the terms of 5U2GGH000570. The contents of this study are solely the responsibility of the authors and do not necessarily represent the official views of CDC. Brendan Maughan-Brown acknowledges support from the National Research Foundation, South Africa, through the Research Career Advancement Fellowship.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflicts of interest.
Ethical approval for the study was obtained from the Ethics Committee of the Human Sciences Research Council (HSRC), South Africa and Centers for Disease Control (CDC), United States. All procedures performed in the study were in accordance with the ethical standards of the HSRC and CDC.
Informed consent was obtained from all individual participants included in the study.
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