Clusters of HIV Risk and Protective Sexual Behaviors in Agincourt, Rural South Africa: Findings from the Ha Nakekela Population-Based Study of Ages 15 and Older
- 30 March 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Archives of Sexual Behavior
- Vol. 49 (6), 2057-2068
- https://doi.org/10.1007/s10508-020-01663-5
Abstract
Understanding how sexual behaviors cluster in distinct population subgroups along the life course is critical for effective targeting and tailoring of HIV prevention messaging and intervention activities. We examined interrelatedness of sexual behaviors and variation between men and women across a wide age range in a rural South African setting with a high HIV burden. Data come from the Ha Nakekela population-based survey of people aged 15-85-plus drawn from the Agincourt Health and Socio-Demographic Surveillance System. We used latent class analysis of six sexual behavior indicators to identify distinct subgroup sexual behavior clusters. We then examined associations between class membership and sociodemographic and other behavioral risk factors and assessed the accuracy of a reduced set of sexual behavior indicators to classify individuals into latent classes. We identified three sexual behavior classes: (1) single with consistent protective behaviors; (2) risky behaviors; and (3) in union with lack of protective behaviors. Patterns of sexual behaviors varied by gender. Class membership was also associated with age, HIV status, nationality, and alcohol use. With only two sexual behavior indicators (union status and multiple sexual partners), individuals were accurately assigned to their most likely predicted class. There were distinct multidimensional sexual behavior clusters in population subgroups that varied by sex, age, and HIV status. In this population, only two brief questions were needed to classify individuals into risk classes. Replication in other situations is needed to confirm these findings.Funding Information
- National Institutes of Health (R24 AG032112)
- National Institute on Aging (R01 AG049634)
This publication has 60 references indexed in Scilit:
- Sexual behaviour in a rural high HIV prevalence South African communityAIDS, 2013
- Prevalence of HIV among those 15 and older in rural South AfricaAIDS Care, 2013
- Transitions in Latent Classes of Sexual Risk Behavior Among Young Injection Drug Users Following HIV Prevention InterventionAIDS and Behavior, 2013
- Profile: Agincourt Health and Socio-demographic Surveillance SystemInternational Journal of Epidemiology, 2012
- Is the Sexual Behaviour of HIV Patients on Antiretroviral therapy safe or risky in Sub-Saharan Africa? Meta-Analysis and Meta-RegressionAIDS Research and Therapy, 2012
- A parallel process growth mixture model of conduct problems and substance use with risky sexual behaviorDrug and Alcohol Dependence, 2010
- Ensuring Positiveness of the Scaled Difference Chi-square Test StatisticPsychometrika, 2009
- Returning home to die: Circular labour migration and mortality in South Africa 1Scandinavian Journal of Public Health, 2007
- Sexual and Drug Behavior Patterns and HIV and STD Racial Disparities: The Need for New DirectionsAmerican Journal of Public Health, 2007
- Gender differences in associations between depressive symptoms and patterns of substance use and risky sexual behavior among a nationally representative sample of U.S. adolescentsArchives of Women's Mental Health, 2006