Advertisement

AIDS and Behavior

, Volume 22, Issue 6, pp 1908–1918 | Cite as

Hope, the Household Environment, and Sexual Risk Behaviors Among Young Women in Rural South Africa (HPTN 068)

  • Lauren M. Hill
  • Laurie Abler
  • Suzanne Maman
  • Rhian Twine
  • Kathleen Kahn
  • Catherine MacPhail
  • Audrey Pettifor
Original Paper

Abstract

We assessed the psychological trait of hope as an explanatory mediator in the relationship between the home environment and sexual risk behaviors among 2533 young women in rural South Africa. Hope mediated the relationship between average household age and sexual debut (mediated effect = − 0.003, p < 0.05), and between household consumption and sexual debut (mediated effect = − 0.019, p < 0.05). Both higher average household age (β = 0.01; 95% CI 0.00, 0.01) and greater household consumption (β = 0.05; 95% CI 0.02, 0.08) were marginally associated with higher hope. In turn, greater hope was associated with lower odds of sexual debut (aOR = 0.62; 95% CI 0.52, 0.74). These results provide important preliminary evidence of the role of the home environment in shaping protective psychological assets and healthy sexual behaviors. Continued exploration of the relationship between hope and the home environment may help to explain why young women in this context have a disproportionate risk for HIV.

Keywords

Hope Household Sexual risk South Africa Young women HIV 

Notes

Acknowledgements

This work was supported by Award Numbers UM1 AI068619 (HPTN Leadership and Operations Center), UM1AI068617 (HPTN Statistical and Data Management Center), UM1AI068613 (HPTN Laboratory Center), and T32AI007001 from the National Institute of Allergy and Infectious Diseases, the National Institute of Mental Health and the National Institute on Drug Abuse of the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Call KT, Riedel AA, Hein K, McLoyd V, Petersen A, Kipke M. Adolescent health and well-being in the twenty-first century: a global perspective. J Res Adolesc. 2002;12(1):69–98.CrossRefGoogle Scholar
  2. 2.
    Gouws E. Trends in HIV prevalence and sexual behaviour among young people aged 15-24 years in countries most affected by HIV. Sex Transm Infect. 2015;86(Suppl 2):ii72–83.Google Scholar
  3. 3.
    Shisana O, Rehle T, Simbayi L, Zuma K, Jooste S. South African national HIV prevalence incidence behaviour and communication survey 2008: a turning tide among teenagers? Cape Town: HSRC Press; 2009Google Scholar
  4. 4.
    Poundstone KE, Strathdee SA, Celentano DD. The social epidemiology of human immunodeficiency virus/acquired immunodeficiency syndrome. Epidemiol Rev. 2004;26:22–35.CrossRefPubMedGoogle Scholar
  5. 5.
    Hallman K. Gendered socioeconomic conditions and HIV risk behaviours among young people in South Africa. Afr J AIDS Res. 2005;4(1):37–50.CrossRefPubMedGoogle Scholar
  6. 6.
    Bell CC, Bhana A, Petersen I, et al. Building protective factors to offset sexually risky behaviors among black youths: a randomized control trial. J Natl Med Assoc. 2008;100:936.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Wittenberg M, Collinson MA. Household transitions in rural South Africa, 1996-2003. Scand J Public Health. 2007;35:130–7.CrossRefGoogle Scholar
  8. 8.
    Foster G. Safety nets for children affected by HIV/AIDS in Southern Africa. A generation at risk. 2004;65–92.Google Scholar
  9. 9.
    Oman RF, Vesely SK, Aspy CB. Youth assets and sexual risk behavior: the importance of assets for youth residing in one-parent households. Perspect Sex Reprod Health. 2005;37(1):25–31.CrossRefPubMedGoogle Scholar
  10. 10.
    Santelli JS, Lowry R, Brener ND, Robin L. The association of sexual behaviors with socioeconomic status, family structure, and race/ethnicity among US adolescents. Am J Public Health. 2000;90(10):1582–8.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Vesely SK, Wyatt VH, Oman RF, et al. The potential protective effects of youth assets from adolescent sexual risk behaviors. J Adolesc Health. 2004;34(5):356–65.CrossRefPubMedGoogle Scholar
  12. 12.
    Tladi LS. Poverty and HIV/AIDS in South Africa: an empirical contribution. SAHARA-J. 2006;3(1):369–81.CrossRefPubMedGoogle Scholar
  13. 13.
    Madhavan S, Townsend N. The social context of children’s nutritional status in rural South Africa 1. Scand J Public Health. 2007;35(69 suppl):107–17.CrossRefGoogle Scholar
  14. 14.
    Madhavan S, Schatz EJ. Coping with change: household structure and composition in rural South Africa, 1992—20031. Scand J Public Health. 2007;35(69 suppl):85–93.CrossRefGoogle Scholar
  15. 15.
    Harris KM, Duncan GJ, Boisjoly J. Evaluating the role of “nothing to lose” attitudes on risky behavior in adolescence. Soc Forces. 2002;80(3):1005–39.CrossRefGoogle Scholar
  16. 16.
    Bishai D, Brahmbhatt H, Gray R, et al. Does biological relatedness affect child survival? Demogr Res. 2003;8:261–78.CrossRefGoogle Scholar
  17. 17.
    Barnett T. HIV/AIDS and hope (lessness). Glob Public Health. 2008;3(3):233–48.CrossRefGoogle Scholar
  18. 18.
    Bernays S, Rhodes T, Barnett T. Hope: a new way to look at the HIV epidemic. AIDS. 2007;21(Suppl 5):S5–11.CrossRefPubMedGoogle Scholar
  19. 19.
    Fischhoff B, Parker AM, de Bruin WB, et al. Teen expectations for significant life events. Public Opin Q. 2000;64(2):189–205.CrossRefPubMedGoogle Scholar
  20. 20.
    Snyder C, Harris C, Anderson J, et al. The will and the ways: development and validation of an individual-differences measure of hope. J Pers Soc Psychol. 1991;60:570–85.CrossRefPubMedGoogle Scholar
  21. 21.
    Stotland E. The psychology of hope: an integration of experimental, clinical, and social approaches. San Francisco: Jossey-Bass; 1969.Google Scholar
  22. 22.
    Aspinwall LG, Leaf SL. In search of the unique aspects of hope: pinning our hopes on positive emotions, future-oriented thinking, hard times, and other people. Psychol Inq. 2002;13:276–88.CrossRefGoogle Scholar
  23. 23.
    Snyder C, Feldman D, Taylor J, Schroeder L, Adams V III. The roles of hopeful thinking in preventing problems and enhancing strengths. Appl Prev Psychol. 2000;9:249–69.CrossRefGoogle Scholar
  24. 24.
    Snyder C, Sympson S, Ybasco F, Borders T, Babyak M, Higgins R. Development and validation of the State Hope Scale. J Pers Soc Psychol. 1996;70:321–35.CrossRefPubMedGoogle Scholar
  25. 25.
    Steyn M, Badenhorst J, Kamper G. Our voice counts: adolescents’ view on their future in South Africa. S Afr J Educ. 2010;30(2):169–88.CrossRefGoogle Scholar
  26. 26.
    Nguyen QC, Villaveces A, Marshall SW, Hussey JM, Halpern CT, Poole C. Adolescent expectations of early death predict adult risk behaviors. PLoS ONE. 2012;7(8):e41905.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Boyce G, Harris G. Hope the beloved country: hope levels in the new South Africa. Soc Indic Res. 2013;113(1):583–97.CrossRefGoogle Scholar
  28. 28.
    Coughlin SS. Hope, ethics, and public health. J Epidemiol Community Health. 2006;60:826.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Barnett T, Weston M. Wealth, health, HIV and the economics of hope. AIDS. 2008;22(Suppl 2):S27–34.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Yadav S. Perceived social support, hope, and quality of life of persons living with HIV/AIDS: a case study from Nepal. Qual Life Res. 2010;19:157–66.CrossRefPubMedGoogle Scholar
  31. 31.
    Kelly A. Hope is forked: hope, loss, treatments, and AIDS dementia. Qual Health Res. 2007;17:866.CrossRefPubMedGoogle Scholar
  32. 32.
    Rhodes T, Bernays S, Terzi K. Medical promise and the recalibration of expectation: hope and HIV treatment engagement in a transitional setting. Soc Sci Med. 2009;68:1050–9.CrossRefPubMedGoogle Scholar
  33. 33.
    Petersen I, Bhana A, Myeza N, et al. Psychosocial challenges and protective influences for socio-emotional coping of HIV+ adolescents in South Africa: a qualitative investigation. AIDS Care. 2010;22:970–8.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Sanchez M, Rice E, Stein J, Milburn N, Rotheram-Borus M. Acculturation, coping styles, and health risk behaviors among HIV positive latinas. AIDS Behav. 2010;14:401–9.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Kylmä J, Vehviläinen-Julkunen K, Lähdevirta J. Hope, despair and hopelessness in living with HIV/AIDS: a grounded theory study. J Adv Nurs. 2001;33:764–75.CrossRefPubMedGoogle Scholar
  36. 36.
    Kagan S, Deardorff J, McCright J, Lightfoot M, Lahiff M, Lippman SA. Hopelessness and sexual risk behavior among adolescent African American males in a low-income urban community. Am J Mens Health. 2012;6(5):395–9.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Bolland JM. Hopelessness and risk behaviour among adolescents living in high-poverty inner-city neighbourhoods. J Adolesc. 2003;26(2):145–58.CrossRefPubMedGoogle Scholar
  38. 38.
    Auerbach JD, Parkhurst JO, Cáceres CF. Addressing social drivers of HIV/AIDS for the long-term response: conceptual and methodological considerations. Glob Public Health. 2011;6(sup3):S293–309.CrossRefPubMedGoogle Scholar
  39. 39.
    Gupta GR, Parkhurst JO, Ogden JA, Aggleton P, Mahal A. Structural approaches to HIV prevention. Lancet. 2008;372:764–75.CrossRefPubMedGoogle Scholar
  40. 40.
    Kahn K, Collinson MA, Gomez-Olive FX, et al. Profile: agincourt health and socio-demographic surveillance system. Int J Epidemiol. 2012;41(4):988–1001.CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Gomez-Olive FX, Angotti N, Houle B, et al. Prevalence of HIV among those 15 and older in rural South Africa. Aids Care. 2013;25(9):1122–8.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Pettifor A, MacPhail C, Selin A, et al. HPTN 068 conditional cash transfer to prevent HIV infection among young women in South Africa: results of a randomized controlled trial. J Int Aids Soc. 2015;18.Google Scholar
  43. 43.
    Abler L, Hill L, Maman S, et al. Hope Matters: developing and validating a measure of future expectations among young women in a high HIV prevalence setting in rural South Africa (HPTN 068). AIDS Behav. 2016;21(7):1–11.Google Scholar
  44. 44.
    Wojcicki JM. Socioeconomic status as a risk factor for HIV infection in women in East, Central and Southern Africa: a systematic review. J Biosoc Sci. 2005;37(01):1–36.CrossRefPubMedGoogle Scholar
  45. 45.
    Rodrigo C, Rajapakse S. HIV, poverty and women. Int Health. 2010;2(1):9–16.CrossRefPubMedGoogle Scholar
  46. 46.
    Wagstaff A, Watanabe N. What difference does the choice of SES make in health inequality measurement? Health Econ. 2003;12(10):885–90.CrossRefPubMedGoogle Scholar
  47. 47.
    Filmer D, Scott K. Assessing asset indices. World Bank policy research working paper series, vol. 2008.Google Scholar
  48. 48.
    Benoit K. Linear regression models with logarithmic transformations. London: London School of Economics; 2011.Google Scholar
  49. 49.
    Hargreaves JR, Morison LA, Chege J, et al. Socioeconomic status and risk of HIV infection in an urban population in Kenya. Trop Med Int Health. 2002;7(9):793–802.CrossRefPubMedGoogle Scholar
  50. 50.
    SAS Institute. SAS version 9.4. 2013.Google Scholar
  51. 51.
    Hayes AF. The PROCESS macro for SPSS and SAS. 2015.Google Scholar
  52. 52.
    Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods. 2008;40:879–91.CrossRefPubMedGoogle Scholar
  53. 53.
    Morgan-Lopez AA, MacKinnon DP. Demonstration and evaluation of a method for assessing mediated moderation. Behav Res Methods. 2006;38(1):77–87.CrossRefPubMedGoogle Scholar
  54. 54.
    Hayes AF. Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. New York: Guilford Press; 2013.Google Scholar
  55. 55.
    MacKinnon DP, Krull JL, Lockwood CM. Equivalence of the mediation, confounding and suppression effect. Prev Sci. 2000;1(4):173–81.CrossRefPubMedPubMedCentralGoogle Scholar
  56. 56.
    Lopez SJ, Rose S, Robinson C, Marques SC, Pais-Ribeiro J. Measuring and promoting hope in school children. In: Handbook of positive psychology in schools. New York, NY: Routledge; 2009. P. 37–51.Google Scholar
  57. 57.
    Dubow EF, Arnett M, Smith K, Ippolito MF. Predictors of future expectations of inner-city children: a 9-month prospective study. J Early Adolesc. 2001;21(1):5–28.CrossRefGoogle Scholar
  58. 58.
    Marques SC, Lopez SJ, Pais-Ribeiro J. “Building hope for the future”: a program to foster strengths in middle-school students. J Happiness Stud. 2011;12(1):139–52.CrossRefGoogle Scholar
  59. 59.
    Kirschman KJB, Roberts MC, Shadlow JO, Pelley TJ. An evaluation of hope following a summer camp for inner-city youth. Child Youth Care Forum. 2010;39(6):385–96.CrossRefGoogle Scholar
  60. 60.
    Shorey HS, Snyder C, Yang X, Lewin MR. The role of hope as a mediator in recollected parenting, adult attachment, and mental health. J Soc Clin Psychol. 2003;22(6):685.CrossRefGoogle Scholar
  61. 61.
    Padilla-Walker LM, Hardy SA, Christensen KJ. Adolescent hope as a mediator between parent-child connectedness and adolescent outcomes. J Early Adolesc. 2010;31(6):853–79.CrossRefGoogle Scholar
  62. 62.
    Diener E, Sandvik E, Seidlitz L, Diener M. The relationship between income and subjective well-being: relative or absolute? Soc Indic Res. 1993;28(3):195–223.CrossRefGoogle Scholar
  63. 63.
    Ferrer-i-Carbonell A. Income and well-being: an empirical analysis of the comparison income effect. J Public Econ. 2005;89(5):997–1019.CrossRefGoogle Scholar
  64. 64.
    Robb KA, Simon AE, Wardle J. Socioeconomic disparities in optimism and pessimism. Int J Behav Med. 2009;16(4):331–8.CrossRefPubMedGoogle Scholar
  65. 65.
    Snyder CR. Measuring hope in children. In: Moore KA, Lippman LH, editors. What do children need to flourish? The search institute series on developmentally attentive community and society, vol 3. Boston, MA: Springer; 2005. P. 61–73.CrossRefGoogle Scholar
  66. 66.
    Eccles JS. Influences of parents’ education on their children’s educational attainments: the role of parent and child perceptions. Lond Rev Educ. 2005;3(3):191–204.CrossRefGoogle Scholar
  67. 67.
    Davis-Kean PE. The influence of parent education and family income on child achievement: the indirect role of parental expectations and the home environment. J Fam Psychol. 2005;19(2):294.CrossRefPubMedGoogle Scholar
  68. 68.
    Wickrama K, Conger RD, Lorenz FO, Elder Jr GH. Parental education and adolescent self-reported physical health. J Marriage Fam. 1998:60(4):967–78.CrossRefGoogle Scholar
  69. 69.
    Collinson MA. Striving against adversity: the dynamics of migration, health and poverty in rural South Africa. Glob Health Action. 2010;3:5080.CrossRefGoogle Scholar
  70. 70.
    Van der Berg S. Apartheid’s enduring legacy: inequalities in education. J Afr Econ. 2007;16(5):849–80.CrossRefGoogle Scholar
  71. 71.
    Pampel FC, Krueger PM, Denney JT. Socioeconomic disparities in health behaviors. Ann Rev Sociol. 2010;36:349–70.CrossRefGoogle Scholar
  72. 72.
    Peltzer K. Early sexual debut and associated factors among in school adolescents in eight African countries. Acta Paediatrica. 2010;99:1242–7.CrossRefPubMedGoogle Scholar
  73. 73.
    Lammers C, Ireland M, Resnick M, Blum R. Influences on adolescents’ decision to postpone onset of sexual intercourse: a survival analysis of virginity among youths aged 13 to 18 years. J Adolesc Health. 2000;26(1):42–8.CrossRefPubMedGoogle Scholar
  74. 74.
    Maxwell KA. Friends: the role of peer influence across adolescent risk behaviors. J Youth Adolesc. 2002;31(4):267–77.CrossRefGoogle Scholar
  75. 75.
    Roeser RW, Eccles JS, Sameroff AJ. School as a context of early adolescents’ academic and social-emotional development: a summary of research findings. Elementary Sch J. 2000;100(5):443–71.CrossRefGoogle Scholar
  76. 76.
    Herth K. Enhancing hope in people with a first recurrence of cancer. J Adv Nurs. 2000;32(6):1431–41.CrossRefPubMedGoogle Scholar
  77. 77.
    Armistead L, Cook S, Skinner D, et al. Preliminary results from a family-based HIV prevention intervention for South African youth. Health Psychol. 2014;33(7):668.CrossRefPubMedGoogle Scholar
  78. 78.
    Bhana A, Petersen I, Mason A, Mahintsho Z, Bell C, McKay M. Children and youth at risk: adaptation and pilot study of the CHAMP (Amaqhawe) programme in South Africa. Afr J AIDS Res. 2004;3(1):33–41.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Lauren M. Hill
    • 1
  • Laurie Abler
    • 1
  • Suzanne Maman
    • 1
  • Rhian Twine
    • 2
  • Kathleen Kahn
    • 2
  • Catherine MacPhail
    • 2
    • 3
    • 4
  • Audrey Pettifor
    • 5
  1. 1.Department of Health BehaviorUNC Chapel HillChapel HillUSA
  2. 2.MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public HealthUniversity of the WitwatersrandJohannesburgSouth Africa
  3. 3.Wits Reproductive Health and HIV InstituteUniversity of the WitwatersrandJohannesburgSouth Africa
  4. 4.School of Health and SocietyUniversity of WollongongWollongongAustralia
  5. 5.Department of EpidemiologyUNC Chapel HillChapel HillUSA

Personalised recommendations