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Do Behavioural Differences Help to Explain Variations in HIV Prevalence in Adolescents in Sub-Saharan Africa?


Chapman, Ruth; White, Richard G.; Shafer, Leigh Anne; Pettifor, Audrey E.; Mugurungi, Owen; Ross, David A.; Pascoe, Sophie; Cowan, Frances M.; Grosskurth, Heiner; & Buve, Anne, et al. (2010). Do Behavioural Differences Help to Explain Variations in HIV Prevalence in Adolescents in Sub-Saharan Africa?. Tropical Medicine and International Health, 15(5), 554-566.


Objective: To compare adolescent risk factors for HIV infection in two countries with high adolescent HIV prevalence and two lower prevalence countries with the aim of identifying risk factors that may help explain differences in adolescent HIV prevalence.
Methods: Data were available from two nationally representative surveys (South Africa, Zimbabwe), two behavioural intervention trials (Tanzania, Zimbabwe) and one population-based cohort (Uganda). Data on variables known or postulated to be risk factors for HIV infection were compared. Results: Few risk behaviours were markedly more common in the high HIV prevalence populations. Risk factors more common in high HIV prevalence settings were genital ulcers and discharge, and women were more likely to report older male partners.
Discussion: Age mixing may be an important determinate of HIV prevalence in adolescents. Potential reasons for the general lack of association between other adolescent risk factors and adolescent HIV prevalence include adult HIV prevalence, misreported behaviour, different survey methods and other unmeasured adolescent behaviours. If adult factors dominate adolescent HIV risk, it would help explain the failure of behavioural interventions targeted at adolescents and suggests future interventions should include adults.


Reference Type

Journal Article

Year Published


Journal Title

Tropical Medicine and International Health


Chapman, Ruth
White, Richard G.
Shafer, Leigh Anne
Pettifor, Audrey E.
Mugurungi, Owen
Ross, David A.
Pascoe, Sophie
Cowan, Frances M.
Grosskurth, Heiner
Buve, Anne
Hayes, Richard J.