Skip to main content
Erschienen in: AIDS and Behavior 7/2015

01.07.2015 | Original Paper

Risk Factors for HIV Acquisition in High Risk Women in a Generalised Epidemic Setting

verfasst von: Nivashnee Naicker, Ayesha B. M. Kharsany, Lise Werner, Francois van Loggerenberg, Koleka Mlisana, Nigel Garrett, Salim S. Abdool Karim

Erschienen in: AIDS and Behavior | Ausgabe 7/2015

Einloggen, um Zugang zu erhalten

Abstract

In South Africa young women bear a disproportionate burden of HIV infection however, risk factors for HIV acquisition are not fully understood in this setting. In a cohort of 245 women, we used proportional hazard regression analysis to examine the association of demographic, clinical and behavioural characteristics with HIV acquisition. The overall HIV incidence rate (IR) was 7.20 per 100 women years (wy), 95 % confidence interval (CI) 4.50–9.80. Women 18–24 years had the highest HIV incidence (IR 13.20 per 100 wy, 95 % CI 6.59–23.62) and were almost three times more likely to acquire HIV compared to women 25 years and older [adjusted Hazard Ratio (aHR) 2.61, 95 % CI 1.05–6.47]. Similarly, women in relationships with multiple sex partners had more than twice the risk of acquiring HIV when compared to women who had no partner or who had a husband or stable partner (aHR 2.47, 95 % CI 0.98–6.26). HIV prevention programmes must address young women’s vulnerability and sex partner reduction in this setting.
Literatur
2.
Zurück zum Zitat Abdool Karim SS, Churchyard GJ, Abdool Karim Q, Lawn SD. HIV infection and tuberculosis in South Africa: an urgent need to escalate the public health response. Lancet. 2009;374(9693):921–33.CrossRefPubMedCentralPubMed Abdool Karim SS, Churchyard GJ, Abdool Karim Q, Lawn SD. HIV infection and tuberculosis in South Africa: an urgent need to escalate the public health response. Lancet. 2009;374(9693):921–33.CrossRefPubMedCentralPubMed
4.
Zurück zum Zitat Pettifor AE, Rees HV, Kleinschmidt I, Steffenson AE, MacPhail C, Hlongwa-Madikizela L, et al. Young people’s sexual health in South Africa: HIV prevalence and sexual behaviors from a nationally representative household survey. AIDS. 2005;19(14):1525–34.CrossRefPubMed Pettifor AE, Rees HV, Kleinschmidt I, Steffenson AE, MacPhail C, Hlongwa-Madikizela L, et al. Young people’s sexual health in South Africa: HIV prevalence and sexual behaviors from a nationally representative household survey. AIDS. 2005;19(14):1525–34.CrossRefPubMed
5.
Zurück zum Zitat Shisana O, Rehle T, Simbayi LC, Zuma K, Jooste S, Zungu N, Labadarios D, Onoya D, et al. South African national HIV prevalence, incidence and behaviour survey, 2012. Cape Town: HSRC Press; 2014. Shisana O, Rehle T, Simbayi LC, Zuma K, Jooste S, Zungu N, Labadarios D, Onoya D, et al. South African national HIV prevalence, incidence and behaviour survey, 2012. Cape Town: HSRC Press; 2014.
6.
Zurück zum Zitat Abdool Karim Q, Kharsany ABM, Frohlich JA, Werner L, Mashego M, Mlotshwa M, et al. Stabilizing HIV prevalence masks high HIV incidence rates amongst rural and urban women in KwaZulu-Natal South Africa. Int J Epidemiol. 2011;40(4):922–30.CrossRefPubMedCentralPubMed Abdool Karim Q, Kharsany ABM, Frohlich JA, Werner L, Mashego M, Mlotshwa M, et al. Stabilizing HIV prevalence masks high HIV incidence rates amongst rural and urban women in KwaZulu-Natal South Africa. Int J Epidemiol. 2011;40(4):922–30.CrossRefPubMedCentralPubMed
7.
Zurück zum Zitat Abdool Karim Q, Kharsany AB, Frohlich JA, Werner L, Mlotshwa M, Madlala BT, et al. HIV incidence in young girls in KwaZulu-Natal, South Africa-public health imperative for their inclusion in HIV biomedical intervention trials. AIDS Behav. 2012;16(7):1870–6.CrossRefPubMed Abdool Karim Q, Kharsany AB, Frohlich JA, Werner L, Mlotshwa M, Madlala BT, et al. HIV incidence in young girls in KwaZulu-Natal, South Africa-public health imperative for their inclusion in HIV biomedical intervention trials. AIDS Behav. 2012;16(7):1870–6.CrossRefPubMed
9.
Zurück zum Zitat Abdool Karim Q, Sibeko S, Baxter C. Preventing HIV infection in women: a global health imperative. Clin Infect Dis. 2010;50(Suppl 3):S122–9.CrossRefPubMed Abdool Karim Q, Sibeko S, Baxter C. Preventing HIV infection in women: a global health imperative. Clin Infect Dis. 2010;50(Suppl 3):S122–9.CrossRefPubMed
10.
Zurück zum Zitat Wand H, Ramjee G. Combined impact of sexual risk behaviors for HIV seroconversion among women in Durban, South Africa: implications for prevention policy and planning. AIDS Behav. 2011;15(2):479–86.CrossRefPubMed Wand H, Ramjee G. Combined impact of sexual risk behaviors for HIV seroconversion among women in Durban, South Africa: implications for prevention policy and planning. AIDS Behav. 2011;15(2):479–86.CrossRefPubMed
11.
Zurück zum Zitat Pettifor AE, Levandowski BA, MacPhail C, Padian NS, Cohen MS, Rees HV. Keep them in school: the importance of education as a protective factor against HIV infection among young South African women. Int J Epidemiol. 2008;37(6):1266–73.CrossRefPubMedCentralPubMed Pettifor AE, Levandowski BA, MacPhail C, Padian NS, Cohen MS, Rees HV. Keep them in school: the importance of education as a protective factor against HIV infection among young South African women. Int J Epidemiol. 2008;37(6):1266–73.CrossRefPubMedCentralPubMed
12.
Zurück zum Zitat Halperin DT. Why is HIV prevalence so severe in Southern Africa? South Afr J HIV Med. 2007;8(1):19–25. Halperin DT. Why is HIV prevalence so severe in Southern Africa? South Afr J HIV Med. 2007;8(1):19–25.
13.
Zurück zum Zitat Leclerc-Madlala S. Age-disparate and intergenerational sex in southern Africa: the dynamics of hypervulnerability. AIDS. 2008;22(Suppl 4):S17–25.CrossRefPubMed Leclerc-Madlala S. Age-disparate and intergenerational sex in southern Africa: the dynamics of hypervulnerability. AIDS. 2008;22(Suppl 4):S17–25.CrossRefPubMed
14.
Zurück zum Zitat Chimbindi NZ, McGrath N, Herbst K, San Tint K, Newell ML. Socio-demographic determinants of condom use among sexually active young adults in rural KwaZulu-Natal, South Africa. Open AIDS J. 2010;4:88–95.CrossRefPubMedCentralPubMed Chimbindi NZ, McGrath N, Herbst K, San Tint K, Newell ML. Socio-demographic determinants of condom use among sexually active young adults in rural KwaZulu-Natal, South Africa. Open AIDS J. 2010;4:88–95.CrossRefPubMedCentralPubMed
15.
Zurück zum Zitat van Loggerenberg F, Dieter AA, Sobieszczyk ME, Werner L, Grobler A, Mlisana K. HIV prevention in high-risk women in South Africa: condom use and the need for change. PLoS One. 2012;7(2):e30669.CrossRefPubMedCentralPubMed van Loggerenberg F, Dieter AA, Sobieszczyk ME, Werner L, Grobler A, Mlisana K. HIV prevention in high-risk women in South Africa: condom use and the need for change. PLoS One. 2012;7(2):e30669.CrossRefPubMedCentralPubMed
17.
Zurück zum Zitat McClelland RS, Lavreys L, Hassan WM, Mandaliya K, Ndinya-Achola JO, Baeten JM. Vaginal washing and increased risk of HIV-1 acquisition among African women: a 10-year prospective study. AIDS. 2006;20(2):269–73.CrossRefPubMed McClelland RS, Lavreys L, Hassan WM, Mandaliya K, Ndinya-Achola JO, Baeten JM. Vaginal washing and increased risk of HIV-1 acquisition among African women: a 10-year prospective study. AIDS. 2006;20(2):269–73.CrossRefPubMed
18.
Zurück zum Zitat Gray RH, Li X, Kigozi G, Serwadda D, Brahmbhatt H, Wabwire-Mangen F, et al. Increased risk of incident HIV during pregnancy in Rakai, Uganda: a prospective study. Lancet. 2005;366(9492):1182–8.CrossRefPubMed Gray RH, Li X, Kigozi G, Serwadda D, Brahmbhatt H, Wabwire-Mangen F, et al. Increased risk of incident HIV during pregnancy in Rakai, Uganda: a prospective study. Lancet. 2005;366(9492):1182–8.CrossRefPubMed
19.
Zurück zum Zitat Myer L, Wright TC Jr, Denny L, Kuhn L. Nested case-control study of cervical mucosal lesions, ectopy, and incident HIV infection among women in Cape Town, South Africa. Sex Transm Dis. 2006;33(11):683–7.CrossRefPubMed Myer L, Wright TC Jr, Denny L, Kuhn L. Nested case-control study of cervical mucosal lesions, ectopy, and incident HIV infection among women in Cape Town, South Africa. Sex Transm Dis. 2006;33(11):683–7.CrossRefPubMed
20.
Zurück zum Zitat Mlisana K, Naicker N, Werner L, Roberts L, van Loggerenberg F, Baxter C, et al. Symptomatic vaginal discharge is a poor predictor of sexually transmitted infections and genital tract inflammation in high-risk women in South Africa. J Infect Dis. 2012;206(1):6–14.CrossRefPubMedCentralPubMed Mlisana K, Naicker N, Werner L, Roberts L, van Loggerenberg F, Baxter C, et al. Symptomatic vaginal discharge is a poor predictor of sexually transmitted infections and genital tract inflammation in high-risk women in South Africa. J Infect Dis. 2012;206(1):6–14.CrossRefPubMedCentralPubMed
21.
Zurück zum Zitat Polis CB, Curtis KM. Use of hormonal contraceptives and HIV acquisition in women: a systematic review of the epidemiological evidence. Lancet Infect Dis. 2013;13(9):797–808.CrossRefPubMed Polis CB, Curtis KM. Use of hormonal contraceptives and HIV acquisition in women: a systematic review of the epidemiological evidence. Lancet Infect Dis. 2013;13(9):797–808.CrossRefPubMed
23.
Zurück zum Zitat van Loggerenberg F, Mlisana K, Williamson C, Auld SC, Morris L, Gray CM, et al. Establishing a cohort at high risk of HIV infection in South Africa: challenges and experiences of the CAPRISA 002 acute infection study. PLoS One. 2008;3(4):e1954.CrossRefPubMedCentralPubMed van Loggerenberg F, Mlisana K, Williamson C, Auld SC, Morris L, Gray CM, et al. Establishing a cohort at high risk of HIV infection in South Africa: challenges and experiences of the CAPRISA 002 acute infection study. PLoS One. 2008;3(4):e1954.CrossRefPubMedCentralPubMed
24.
Zurück zum Zitat Abdool Karim SS, Mlisana K, Kharsany A, Williamson C, Baxter C, Karim Q. Utilizing nucleic acid amplification to identify acute HIV infection. AIDS. 2007;21(5):653–5.CrossRef Abdool Karim SS, Mlisana K, Kharsany A, Williamson C, Baxter C, Karim Q. Utilizing nucleic acid amplification to identify acute HIV infection. AIDS. 2007;21(5):653–5.CrossRef
25.
Zurück zum Zitat Kingsley LA, Detels R, Kaslow R, Polk BF, Rinaldo CR Jr, Chmiel J, et al. Risk factors for seroconversion to human immunodeficiency virus among male homosexuals. Results from the Multicenter AIDS Cohort Study. Lancet. 1987;1(8529):345–9.CrossRefPubMed Kingsley LA, Detels R, Kaslow R, Polk BF, Rinaldo CR Jr, Chmiel J, et al. Risk factors for seroconversion to human immunodeficiency virus among male homosexuals. Results from the Multicenter AIDS Cohort Study. Lancet. 1987;1(8529):345–9.CrossRefPubMed
26.
Zurück zum Zitat Abdool Karim SS, Ramjee G. Anal sex and HIV transmission in women. Am J Public Health. 1998;88(8):1265–6.CrossRef Abdool Karim SS, Ramjee G. Anal sex and HIV transmission in women. Am J Public Health. 1998;88(8):1265–6.CrossRef
27.
Zurück zum Zitat Heffron R, Donnell D, Rees H, Celum C, Mugo N, Were E, et al. Use of hormonal contraceptives and risk of HIV-1 transmission: a prospective cohort study. Lancet Infect Dis. 2012;12(1):19–26.CrossRefPubMedCentralPubMed Heffron R, Donnell D, Rees H, Celum C, Mugo N, Were E, et al. Use of hormonal contraceptives and risk of HIV-1 transmission: a prospective cohort study. Lancet Infect Dis. 2012;12(1):19–26.CrossRefPubMedCentralPubMed
28.
Zurück zum Zitat Hel Z, Stringer E, Mestecky J. Sex steroid hormones, hormonal contraception, and the immunobiology of human immunodeficiency virus-1 infection. Endocr Rev. 2010;31(1):79–97.CrossRefPubMedCentralPubMed Hel Z, Stringer E, Mestecky J. Sex steroid hormones, hormonal contraception, and the immunobiology of human immunodeficiency virus-1 infection. Endocr Rev. 2010;31(1):79–97.CrossRefPubMedCentralPubMed
29.
Zurück zum Zitat Ramjee G, Kapiga S, Weiss S, Peterson L, Leburg C, Kelly C, et al. The value of site preparedness studies for future implementation of phase 2/IIb/III HIV prevention trials: experience from the HPTN 055 study. J Acquir Immune Defic Syndr. 2008;47(1):93–100.CrossRefPubMed Ramjee G, Kapiga S, Weiss S, Peterson L, Leburg C, Kelly C, et al. The value of site preparedness studies for future implementation of phase 2/IIb/III HIV prevention trials: experience from the HPTN 055 study. J Acquir Immune Defic Syndr. 2008;47(1):93–100.CrossRefPubMed
30.
Zurück zum Zitat Moodley D, Esterhuizen TM, Pather T, Chetty V, Ngaleka L. High HIV incidence during pregnancy: compelling reason for repeat HIV testing. AIDS. 2009;23(10):1255–9.CrossRefPubMed Moodley D, Esterhuizen TM, Pather T, Chetty V, Ngaleka L. High HIV incidence during pregnancy: compelling reason for repeat HIV testing. AIDS. 2009;23(10):1255–9.CrossRefPubMed
31.
Zurück zum Zitat Kumwenda N, Hoffman I, Chirenje M, Kelly C, Coletti A, Ristow A, et al. HIV incidence among women of reproductive age in Malawi and Zimbabwe. Sex Transm Dis. 2006;33(11):646–51.CrossRefPubMed Kumwenda N, Hoffman I, Chirenje M, Kelly C, Coletti A, Ristow A, et al. HIV incidence among women of reproductive age in Malawi and Zimbabwe. Sex Transm Dis. 2006;33(11):646–51.CrossRefPubMed
32.
Zurück zum Zitat Bulterys M, Chao A, Habimana P, Dushimimana A, Nawrocki P, Saah A. Incident HIV-1 infection in a cohort of young women in Butare. Rwanda. AIDS. 1994;8(11):1585–91.PubMed Bulterys M, Chao A, Habimana P, Dushimimana A, Nawrocki P, Saah A. Incident HIV-1 infection in a cohort of young women in Butare. Rwanda. AIDS. 1994;8(11):1585–91.PubMed
33.
Zurück zum Zitat Harling G, Newell ML, Tanser F, Kawachi I, Subramanian SV, Barnighausen T. Do age-disparate relationships drive hiv incidence in young women? Evidence from a population cohort in rural KwaZulu-Natal, South Africa. J Acquir Immune Defic Syndr. 2014;66(4):443–51.CrossRefPubMed Harling G, Newell ML, Tanser F, Kawachi I, Subramanian SV, Barnighausen T. Do age-disparate relationships drive hiv incidence in young women? Evidence from a population cohort in rural KwaZulu-Natal, South Africa. J Acquir Immune Defic Syndr. 2014;66(4):443–51.CrossRefPubMed
35.
Zurück zum Zitat Chen L, Jha P, Stirling B, Sgaier SK, Daid T, Kaul R, et al. Sexual risk factors for HIV infection in early and advanced HIV epidemics in sub-Saharan Africa: systematic overview of 68 epidemiological studies. PLoS One. 2007;2(10):e1001.CrossRefPubMedCentralPubMed Chen L, Jha P, Stirling B, Sgaier SK, Daid T, Kaul R, et al. Sexual risk factors for HIV infection in early and advanced HIV epidemics in sub-Saharan Africa: systematic overview of 68 epidemiological studies. PLoS One. 2007;2(10):e1001.CrossRefPubMedCentralPubMed
36.
Zurück zum Zitat Zuma K, Gouws E, Williams B, Lurie M. Risk factors for HIV infection among women in Carletonville, South Africa: migration, demography and sexually transmitted diseases. Int J STD AIDS. 2003;14(12):814–7.CrossRefPubMed Zuma K, Gouws E, Williams B, Lurie M. Risk factors for HIV infection among women in Carletonville, South Africa: migration, demography and sexually transmitted diseases. Int J STD AIDS. 2003;14(12):814–7.CrossRefPubMed
37.
Zurück zum Zitat Mavedzenge SN, Weiss HA, Montgomery ET, Blanchard K, de Bruyn G, Ramjee G, et al. Determinants of differential HIV incidence among women in three southern African locations. J Acquir Immune Defic Syndr. 2011;58(1):89–99.CrossRefPubMed Mavedzenge SN, Weiss HA, Montgomery ET, Blanchard K, de Bruyn G, Ramjee G, et al. Determinants of differential HIV incidence among women in three southern African locations. J Acquir Immune Defic Syndr. 2011;58(1):89–99.CrossRefPubMed
39.
Zurück zum Zitat Morrison CS, Skoler-Karpoff S, Kwok C, Chen PL, van de Wijgert J, Gehret-Plagianos M, et al. Hormonal contraception and the risk of HIV acquisition among women in South Africa. AIDS. 2012;26(4):497–504.CrossRefPubMed Morrison CS, Skoler-Karpoff S, Kwok C, Chen PL, van de Wijgert J, Gehret-Plagianos M, et al. Hormonal contraception and the risk of HIV acquisition among women in South Africa. AIDS. 2012;26(4):497–504.CrossRefPubMed
40.
Zurück zum Zitat Sviri S, Khalaila R, Daher S, Bayya A, Linton DM, Stav I, et al. Increased Vitamin B12 levels are associated with mortality in critically ill medical patients. Clin Nutr. 2012;31(1):53–9.CrossRefPubMed Sviri S, Khalaila R, Daher S, Bayya A, Linton DM, Stav I, et al. Increased Vitamin B12 levels are associated with mortality in critically ill medical patients. Clin Nutr. 2012;31(1):53–9.CrossRefPubMed
41.
Zurück zum Zitat Salles N, Herrmann F, Sakbani K, Rapin CH, Sieber C. High vitamin B12 level: a strong predictor of mortality in elderly inpatients. J Am Geriatr Soc. 2005;53(5):917–8.CrossRefPubMed Salles N, Herrmann F, Sakbani K, Rapin CH, Sieber C. High vitamin B12 level: a strong predictor of mortality in elderly inpatients. J Am Geriatr Soc. 2005;53(5):917–8.CrossRefPubMed
42.
Zurück zum Zitat Nelson RM, Lewis LL, Struble K, Wood SF. Ethical and regulatory considerations for the inclusion of adolescents in HIV biomedical prevention research. J Acquir Immune Defic Syndr. 2010;54(Suppl 1):S18–24.CrossRefPubMed Nelson RM, Lewis LL, Struble K, Wood SF. Ethical and regulatory considerations for the inclusion of adolescents in HIV biomedical prevention research. J Acquir Immune Defic Syndr. 2010;54(Suppl 1):S18–24.CrossRefPubMed
Metadaten
Titel
Risk Factors for HIV Acquisition in High Risk Women in a Generalised Epidemic Setting
verfasst von
Nivashnee Naicker
Ayesha B. M. Kharsany
Lise Werner
Francois van Loggerenberg
Koleka Mlisana
Nigel Garrett
Salim S. Abdool Karim
Publikationsdatum
01.07.2015
Verlag
Springer US
Erschienen in
AIDS and Behavior / Ausgabe 7/2015
Print ISSN: 1090-7165
Elektronische ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-015-1002-5

Weitere Artikel der Ausgabe 7/2015

AIDS and Behavior 7/2015 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

24.05.2024 Mammakarzinom Nachrichten

In der MONARCHE-3-Studie lebten Frauen mit fortgeschrittenem Hormonrezeptor-positivem, HER2-negativem Brustkrebs länger, wenn sie zusätzlich zu einem nicht steroidalen Aromatasehemmer mit Abemaciclib behandelt wurden; allerdings verfehlte der numerische Zugewinn die statistische Signifikanz.

ADT zur Radiatio nach Prostatektomie: Wenn, dann wohl länger

24.05.2024 Prostatakarzinom Nachrichten

Welchen Nutzen es trägt, wenn die Strahlentherapie nach radikaler Prostatektomie um eine Androgendeprivation ergänzt wird, hat die RADICALS-HD-Studie untersucht. Nun liegen die Ergebnisse vor. Sie sprechen für länger dauernden Hormonentzug.

„Überwältigende“ Evidenz für Tripeltherapie beim metastasierten Prostata-Ca.

22.05.2024 Prostatakarzinom Nachrichten

Patienten mit metastasiertem hormonsensitivem Prostatakarzinom sollten nicht mehr mit einer alleinigen Androgendeprivationstherapie (ADT) behandelt werden, mahnt ein US-Team nach Sichtung der aktuellen Datenlage. Mit einer Tripeltherapie haben die Betroffenen offenbar die besten Überlebenschancen.

So sicher sind Tattoos: Neue Daten zur Risikobewertung

22.05.2024 Melanom Nachrichten

Das größte medizinische Problem bei Tattoos bleiben allergische Reaktionen. Melanome werden dadurch offensichtlich nicht gefördert, die Farbpigmente könnten aber andere Tumoren begünstigen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.