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International Journal for Equity in Health
Published in: International Journal for Equity in Health 1/2019

Open Access 01-12-2019 | Human Immunodeficiency Virus | Research

HIV prevalence in South Africa through gender and racial lenses: results from the 2012 population-based national household survey

Authors: M. Mabaso, L. Makola, I. Naidoo, L. L. Mlangeni, S. Jooste, L. Simbayi

Published in: International Journal for Equity in Health | Issue 1/2019

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Abstract

Background

In South Africa, persistence of the HIV epidemic and associated gender and racial disparities is a major concern after more than 20 years of democratic dispensation and efforts to create a more healthy and equal society. This paper profiles HIV prevalence and related factors among Black African men and women compared to other race groups in South Africa using the 2012 population-based national household HIV survey.

Methods

This secondary data analysis was based on the 2012 population-based nationally representative multi-stage stratified cluster random household sample. Bivariate and multiple logistic regression analysis were used to assess the relationship between HIV prevalence and associated factors by gender and racial profile.

Results

Overall HIV prevalence was significantly higher (p < 0.001) among both Black African males (16.6%; 95% CI: 15.0–18.4) and females (24.1%; 95% CI: 22.4–26.0) compared to their counterparts from other races. Among Black African males, increased risk of HIV was significantly associated with age group 25–49 years and those 50 years and older compared with young males 15–25 years. Among all males, reported condom use at last sex was significantly associated with increased risk of HIV. High socio-economic status (SES) and perceived risk of HIV were associated with a decreased risk of HIV. Among female condom use at last sex and ever testing for HIV was associated with increased prevalence of HIV only among Black African females. Lower prevalence of HIV was associated with marriage, tertiary education, high SES, having a partner five years younger, perceived risk of HIV, and awareness of HIV status among Black African females.

Conclusion

Gender and racial disparities rooted in structural and contextual inequalities remain important factors for the maintenance of the generalized HIV epidemic in the country. HIV prevention interventions need to cut across all strata of society but also target risk factors salient for specific groups. Alleviating vulnerability to HIV along gender and racial lines should also be viewed as part of a broader public health strategy.
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Literature
1.
Richardson ET, Collins SE, Kung T, Jones JH, Hoan Tram K, Boggiano VL, Bekker LG, Zolopa AR. Gender inequality and HIV transmission: a global analysis. J Int AIDS Soc. 2014;17:19035.PubMedPubMedCentralCrossRef
2.
Shisana O, Rehle T, Simbayi LC, Zuma K, Jooste S, Zungu N, et al. South African national HIV prevalence, incidence and behavior survey, 2012. Cape Town: HSRC Press; 2014.
3.
Harrison A, Colvin CJ, Kuo C, Swartz A, Lurie M. Sustained high HIV incidence in young women in southern Africa: social, behavioral, and structural factors and emerging intervention approaches. Curr HIV/AIDS Rep. 2015;12(2):207–15.PubMedPubMedCentralCrossRef
4.
Zuma K, Shisana O, Rehle TM, Simbayi LC, Jooste S, Zungu N, et al. New insights into HIV epidemic in South Africa: key findings from the national HIV prevalence, incidence and behaviour survey, 2012. Afr J AIDS Res. 2016;15(1):67–75.PubMedCrossRef
5.
Shisana O, Simbayi L. Nelson Mandela HSRC study of HIV/AIDS. South African national HIV prevalence, behavioural risks and mass media. Household survey 2002. Pretoria: HSRC; 2002.
6.
Shisana O, Rehle T, Simbayi LC, Parker R, Zuma K, Bhana A, et al. South African national HIV prevalence, HIV incidence, behaviour and communication survey, 2005. Cape Town: HSRC Press; 2005.
7.
Shisana O, Rehle T, Simbayi L, Zuma K, Jooste S, Pillay-van-Wyk V, et al. South African national HIV prevalence, incidence, behaviour and communication survey 2008: a turning tide among teenagers. Cape Town: HSRC Press; 2009.
8.
9.
Gilbert L, Selikow TA. The epidemic in this country has the face of a woma: gender and HIV/AIDS in South Africa. Afr J AIDS Res. 2011;10(supp1):325–34.PubMedCrossRef
10.
Williams DR, Priest N, Anderson NB. Understanding associations among race, socioeconomic status, and health: patterns and prospects. Health Psychol. 2016;35(4):407–11.PubMedPubMedCentralCrossRef
11.
Shisana O, Zungu N, Evans M, Rehle T, Risher K, Celentano D. The case for expanding the definition of'key populations' to include high-risk groups in the general population to improve targeted HIV prevention efforts. S Afr Med J. 2015;105(8):664–9.PubMedCrossRef
12.
Pascoe SJS, Langhaug LF, Mavhu W, Hargreaves J, Jaffar S, Hayes R, et al. Poverty, food insufficiency and HIV infection and sexual behaviour among young rural Zimbabwean women. PLoS One. 2015;10(1):e0115290.PubMedPubMedCentralCrossRef
13.
Awoleye OJ, Thron C. Determinants of human immunodeficiency virus (HIV) infection in Nigeria: a synthesis of the literature. J AIDS HIV Res. 2015;7(9):117–1129.CrossRef
14.
Sia D, Onadja Y, Nandi A, Foro A, Brewer T. What lies behind gender inequalities in HIV/AIDS in sub-Saharan African countries: evidence from Kenya, Lesotho and Tanzania. Health Policy Plan. 2013;29(7):938–49.PubMedPubMedCentralCrossRef
15.
Zembe YZ, Townsend L, Thorson A, Ekström AM. “Money talks, bullshit walks” interrogating notions of consumption and survival sex among young women engaging in transactional sex in post-apartheid South Africa: a qualitative enquiry. Global Health. 2013;9(1):28.PubMedPubMedCentralCrossRef
16.
Stoebenaua K, Heiseb L, Wamoyic J, Bobrovad N. Revisiting the understanding of “transactional sex” in sub-Saharan Africa: a review and synthesis of the literature. Soc Sci Med. 2016;168:186–97.CrossRef
17.
UNAIDS. Ending AIDS: Progress towards the 90–90-90 targets. Geneva: UNAIDS; 2017.
18.
UNAIDS. Prevention gap report. Geneva: UNAIDS; 2016.
19.
Bogart LM, Wagner G, Galvan F, Banks D. Conspiracy beliefs about HIV are related to antiretroviral treatment nonadherence among African American men with HIV. J Acquir Immune Defic Syndr. 2010;53(5):648–55.PubMedPubMedCentralCrossRef
20.
El-Bassel N, Caldeira NA, Ruglass LM, Gilbert L. Addressing the unique needs of African American women in HIV prevention. Am J Public Health. 2009;99(6):996–1001.PubMedPubMedCentralCrossRef
21.
22.
Benatar SR. The challenges of health disparities in South Africa. S Afr Med J. 2013;103(3):154–5.PubMedCrossRef
23.
David A, Guilbert N, Hino H, Leibbrandt M, Potgieter E, Shifa M. Social cohesion and inequality in South Africa. Cape Town: SALDRU, UCT. (SALDRU Working Paper Number 219); 2018.
24.
Statistics South Africa. Census in brief. South Africa: Statistics Pretoria; 2001.
25.
UNAIDS/WHO. Guidelines for second generation HIV surveillance. Working group on Global HIV/AIDS and STI surveillance, joint effort of the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS). Geneva: UNAIDS; 2000.
26.
Seekings J. The continuing salience of race: discrimination and diversity in South Africa. J Contemp Afr Stud. 2008;26(1):1–25.CrossRef
27.
Census 2011. Census in brief. Pretoria: Statistics South Africa. p. 2012.
28.
Booysen F, van der Berg S, Burger R, von Maltitz M, du Rand G. Using an asset index to assess trends in poverty in seven sub-Saharan African countries. World Develop Rep. 2008;36:1113–30.CrossRef
29.
Saunders JB, Aasland OG, Babor TF, De la Fuente JR, Grant M. Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction. 1993;88(6):791–804.PubMedCrossRef
30.
Jann B. Plotting regression coefficients and other estimates. Stata J. 2014;14(4):708–37.CrossRef
31.
Fox AM. The HIV–poverty thesis re-examined: poverty, wealth or inequality as a social determinant of HIV infection in sub-Saharan Africa? J Biosoc Sci. 2012;44(4):459–80.PubMedCrossRef
32.
Vaughan AS, Rosenberg E, Shouse RL, Sullivan PS. Connecting race and place: a county-level analysis of white, black, and Hispanic HIV prevalence, poverty, and level of urbanization. Am J Public Health. 2014;104(7):e77–84.PubMedPubMedCentralCrossRef
33.
Hunter M. The changing political economy of sex in South Africa: the significance of unemployment and inequalities to the scale of the AIDS pandemic. Soc Sci Med. 2007;64(3):689–700.PubMedCrossRef
34.
Tenkorang EY. Marriage, widowhood, divorce and HIV risks among women in sub-Saharan Africa. Int Health. 2014;6(1):46–53.PubMedCrossRef
35.
36.
Osuafor GN, Mturi J. Attitude towards sexual control among women in conjugal union in the era of the HIV/AIDS epidemic in Mahikeng, South Africa. Afr Popul Stud. 2014;28(1):538.CrossRef
37.
Sia D, Onadja Y, Hajizadeh M, Heymann SJ, Brewer TF, Nandi A. What explains gender inequalities in HIV/AIDS prevalence in sub-Saharan Africa? Evidence from the demographic and health surveys. BMC Public Health. 2016;16:1136.PubMedPubMedCentralCrossRef
38.
Maughan-Brown B, Evans M, George G. Sexual behaviour of men and women within age-disparate partnerships in South Africa: implications for young Women's HIV risk. PLoS One. 2016;11(8):e0159162.PubMedPubMedCentralCrossRef
39.
Evans M, Risher K, Zungu N, Shisana O, Moyo S, Celentano DD, Maughan-Brown B, Rehle TM. Age-disparate sex and HIV risk for young women from 2002 to 2012 in South Africa. J Int AIDS Soc. 2016;19(1):21310.PubMedCentralCrossRef
40.
41.
Dodoo FN-A, Zulu EM, Ezeh AC. Urban–rural differences in the socioeconomic deprivation–sexual behavior link in Kenya. Soc Sci Med. 2007;64(5):1019–31.PubMedCrossRef
42.
Odimegwu CO, Amoo EO, De Wet N. Teenage pregnancy in South Africa: Where are the young men involved? S Afr J Child Health. 2018;12(2 Suppl 1):S44–50.
Metadata
Title
HIV prevalence in South Africa through gender and racial lenses: results from the 2012 population-based national household survey
Authors
M. Mabaso
L. Makola
I. Naidoo
L. L. Mlangeni
S. Jooste
L. Simbayi
Publication date
01-12-2019
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2019
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-019-1055-6

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