Risk factors associated with HIV infection among young persons aged 15–24 years: Evidence from an in-depth analysis of the 2005–06 Zimbabwe Demographic and Health Survey

Abstract

This study focuses on factors that predispose young persons aged 15-24 years in Zimbabwe to infection from HIV. Using the Mosley and Chen framework, multivariate modelling was used to assess the effect of demographic, socio-economic and behavioural factors on the risk of HIV infection among this target group. The study utilised data from the Zimbabwe Demographic and Health Survey (ZDHS) conducted in 2005-06. Only the variables that were significant in the bivariate analysis were included in the multivariate binary logistic regression. Young females aged 15-24 years are associated with a significant two-fold elevated risk of HIV infection relative to their male peers (p < 0.000). Young persons aged 15-24 years who were divorced, widowed or not living together have significantly elevated risk compared with their never-married counterparts, OR = 5.267 (p = 0.000); OR = 4.323 (p = 0.000) and OR = 3.272 (p = 0.000), respectively. Young persons whose age at first sexual intercourse was less than 14 years are significantly associated with 2.696 times more risk of HIV infection relative to their peers whose age at first sexual intercourse was 20-24 years (p = 0.000). Young persons aged 15-24 years with two or more sex partners in the past 12 months preceding the 2005-06 ZDHS survey had a significantly elevated risk of HIV infection of 1.568 times relative to their counterparts with no sex partners in the same period of time. Great challenges still exist for the control of HIV and AIDS among young persons in Zimbabwe. HIV prevention programmes targeted at young persons aged 15-24 years should provide invigorated focus on marital status, age at sexual debut, number of sexual partners, sexually transmitted infections and condom use so as to mitigate these predisposing factors for HIV infection.

Spatial analysis of factors associated with HIV infection among young people in Uganda, 2011

“…Young persons who engage in early sexual relationships are likely to have more sexual partners than their counterparts whose sexual debut occurs later predisposing them to contracting HIV and other STIs. This observation is consistent with findings from Zimbabwe which observed that a younger coital debut was associated with an increased likelihood in HIV infection compared to a later coital debut [39]. …”

“…The overall results showed that HIV risk was higher among currently and previously married individuals, low circumcision rates and high-risk sexual behaviours. These findings are consistent with those observed in previous studies based on DHS data [12,14,17,39,41,44]. A possible explanation for increased likelihood for HIV infections among divorced/separated individuals could be that previously married individuals tend to have more sexual partners than single or married individuals [45].…”

“…It is of interest to note that the effect of behavioural variables on the risk of HIV infection in the multivariable logistic models is reduced after controlling for the demographic factors. Efforts to control the spread of HIV/AIDS among young persons should focus on eradicating behavioural factors which have been known to propagate the epidemic [39]. …”

“…These young persons could most probably have married young and transitioned from virginity to frequent unprotected sex, which they would likely continue to engage in after the end of marriage. A possibility that some of the young persons could have been infected while married and could have been separated or divorced at the recognition that they were infected with HIV could also arise [39,46]. Programmes and interventions for the control of HIV/AIDS should also focus on young widowed and divorced young persons as well as promoting approriate prevention strategies such as condom use and abstinence from sexual activities in order to prevent contracting HIV or other STIs [31,39,41,46].…”

Seeking wider access to HIV testing for adolescents in sub-Saharan Africa

“…However, beyond 14 y, female adolescents have much higher HIV incidence and prevalence as compared to males (7,8,(59)(60)(61) ( Table 1). Pregnant adolescent females (46,47), adolescents with early sexual debut, married, or partnered but living separately, engaging in transactional sex, especially in rural areas (62,63), having multiple or older sexual partners (59,60,64), and those experiencing high mobility and labor migration (65,66), have also been identified to be at increased risk of HIV infection and unfavorable outcomes. Lastly, the significant proportions of perinatally-infected individuals surviving into young adolescence and young adulthood should not be overlooked (51,61,67).…”