Effect of Quality of Caregiver-Adolescent Relationship on Sexual Debut, Transactional Sex, and on Age-Disparate Relationships among Young Women in Rural South Africa Enrolled in HPTN 068

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Citation

Shangase, Nosipho; Edwards, Jessie K.; Pence, Brian W.; Aiello, Allison E.; Hussong, Andrea M.; Gómez-Olivé, Xavier; Kahn, Kathleen; Stoner, Marie C. D.; & Pettifor, Audrey E. (2022). Effect of Quality of Caregiver-Adolescent Relationship on Sexual Debut, Transactional Sex, and on Age-Disparate Relationships among Young Women in Rural South Africa Enrolled in HPTN 068. Journal of Acquired Immune Deficiency Syndrome, 89(4), 366-373. PMCID: PMC8887792

Abstract

BACKGROUND: Adolescent girls and young women (AGYW) remain burdened by the HIV epidemic. Positive caregiver-child relationships are associated with safe sexual behaviors in young people; yet, this literature often highlights the role of parent-child communication and parental monitoring, neglecting the importance of emotional relationships between a caregiver and adolescent.
SETTING: We used longitudinal data from HIV Prevention Trial Network 068-conducted among 2533 AGYW (13-20 years) over a period of 5 years in Agincourt, South Africa.
METHOD: Kaplan-Meier and Cox models were used to estimate the effect of quality of caregiver-adolescent relationships (caring and closeness) on sexual debut, and log-binomial models with generalized estimating equations were used to examine the relationship between our exposures and transactional sex and age-disparate relationships.
RESULTS: Sexual debut was delayed among those who reported high levels of caregiver caring [hazard ratio: 0.80, 95% confidence interval (CI): 0.69 to 0.93] and caregiver closeness (hazard ratio: 0.80, 95% CI: 0.68 to 0.95). AGYW who reported high quality caregiver-adolescent relationships had a lower risk of transactional sex [caring: risk ratio (RR): 0.67, 95% CI: 0.58 to 0.78; closeness: RR: 0.58; 95% CI: 0.50 to 0.67]. Similarly, those with high-quality caregiver-adolescent relationships were less likely to be in an age-disparate relationship (caring: RR: 0.68, 95% CI: 0.58 to 0.79; closeness: RR: 0.77, 95% CI: 0.66 to 0.90).
CONCLUSIONS: Findings indicate high-quality caregiver-adolescent relationships are associated with delayed sexual debut, a lower risk of transactional sex, and having an older partner. Family-centered interventions are needed to improve relationships between AGYW and caregivers.

URL

http://dx.doi.org/10.1097/qai.0000000000002890

Reference Type

Journal Article

Year Published

2022

Journal Title

Journal of Acquired Immune Deficiency Syndrome

Author(s)

Shangase, Nosipho
Edwards, Jessie K.
Pence, Brian W.
Aiello, Allison E.
Hussong, Andrea M.
Gómez-Olivé, Xavier
Kahn, Kathleen
Stoner, Marie C. D.
Pettifor, Audrey E.

Article Type

Regular

PMCID

PMC8887792

Data Set/Study

HIV Prevention Trials Network (HPTN)

Continent/Country

South Africa

Sex/Gender

Women

ORCiD

Aiello - 0000-0001-7029-2537
Pettifor - 0000-0002-3387-0817