Citation
Nguyen, Nadia L.; Powers, Kimberly A.; Miller, William C.; Howard, Annie Green; Halpern, Carolyn Tucker; Hughes, James P.; Wang, Jing; Twine, Rhian; Gomez-Olive, F. Xavier; & MacPhail, Catherine Lorne, et al. (2019). Sexual Partner Types and Incident HIV Infection among Rural South African Adolescent Girls and Young Women Enrolled in HPTN 068: A Latent Class Analysis. Journal of Acquired Immune Deficiency Syndromes, 82(1), 25-33. PMCID: PMC6692200Abstract
BACKGROUND: Sexual partners are the primary source of incident HIV infection among adolescent girls and young women (AGYW) in sub-Saharan Africa. Identifying partner types at greatest risk of HIV transmission could guide the design of tailored HIV prevention interventions.METHODS: We conducted a secondary analysis of data from AGYW (ages 13-23) enrolled in a randomized controlled trial of cash transfers for HIV prevention in South Africa. Annually, AGYW reported behavioral and demographic characteristics of their three most recent sexual partners, categorized each partner using pre-specified labels, and received HIV testing. We used latent class analysis (LCA) to identify partner types from reported characteristics, and generalized estimating equations to estimate the relationship between both LCA-identified and pre-specified partner types and incident HIV infection.
RESULTS: Across 2140 AGYW-visits, 1034 AGYW made 2968 partner-reports, and 63 AGYW acquired HIV infection. We identified five LCA partner types, which we named monogamous HIV-negative peer partner; one-time protected in-school peer partner; out-of-school older partner; anonymous out-of-school peer partner; and cohabiting with children in-school peer partner. Compared to AGYW with only monogamous HIV-negative peer partners, AGYW with out-of-school older partners had 2.56 times the annual risk of HIV infection (95% CI: 1.23, 5.33), while AGYW with anonymous out-of-school peer partners had 1.72 times the risk (95% CI: 0.82, 3.59). Pre-specified partner types were not associated with incident HIV.
CONCLUSION: By identifying meaningful combinations of partner characteristics and predicting the corresponding risk of HIV acquisition among AGYW, LCA-identified partner types may provide new insights for the design of tailored HIV prevention interventions.
URL
http://dx.doi.org/10.1097/qai.0000000000002096Reference Type
Journal ArticleYear Published
2019Journal Title
Journal of Acquired Immune Deficiency SyndromesAuthor(s)
Nguyen, Nadia L.Powers, Kimberly A.
Miller, William C.
Howard, Annie Green
Halpern, Carolyn Tucker
Hughes, James P.
Wang, Jing
Twine, Rhian
Gomez-Olive, F. Xavier
MacPhail, Catherine Lorne
Kahn, Kathleen
Pettifor, Audrey E.