AEGiS-14IAC: Early age of coital debut and intergenerational sex are risk factors for HIV among Zimbabwean women.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Early age of coital debut and intergenerational sex are risk factors for HIV among Zimbabwean women.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. ThOrC1489)

van der Straten A, Pettifor A, Dunbar M, Chipato T, Padian N
UCSF, San Francisco, United States

BACKGROUND: Early age of coital debut and older male partners (intergenerational sex) may be risk factors that partially explain the high rates of HIV infection among young women in sub Saharan Africa.

METHODS: Using data from a longitudinal study examining the effect of hormonal contraception on HIV acquisition in Zimbabwean women, we evaluated the relationship between 1) early age of coital debut and prevalent HIV infection at screening and 2) the effect of having an older partner on the use of condoms at baseline. Multivariate logistic regression was used to examine the relationship between the main predictors and outcomes, controlling for covariates.

RESULTS: Among 2,782 women screened, 39% were HIV infected; 13% reported coital debut at age =<15, 29% at age 16-17, and 58% at age >=18. In multivariate analyses, the odds of HIV infection was 1.7 (95% CI 1.3-2.2) among women who experienced coital debut at age =<15 compared to those at age >=18, controlling for age, lifetime number of partners, ever use of condoms, and living with partner. Of the 1,326 HIV seronegative women with complete baseline information, 22% had never used a condom; 40% had a partner who was <5 years older, 42% had a partner who was 5-9 years older and 18% had a partner who was >=10 years their senior. In multivariate analyses, the odds ratio for never having used a male condom was 2.1 (95% CI 1.4- 3.0) among women with a partner >=10 years older, compared to women with a partner <5 years older, controlling for age, age of coital debut, lifetime number of partners, and use of hormonal method.

CONCLUSIONS: Early age of coital debut was associated with an increased risk of HIV, independent of condom use. In addition, among seronegative women, having a >=10 years older male partner increased the risk of never having used a male condom. These findings have important implications for HIV prevention programs targeting young women in Africa.

Keywords: AEGIS, Risk Factors, HIV Infections, Condoms, Coitus, Age Factors, Sex, HIV Seropositivity, Condoms, Female, Logistic Models, Sex Factors, Sex Education, Longitudinal Studies, Africa, Africa South of the Sahara, Human, Female, Male

020707
ThOrC1489