Economic Resources and HIV Preventive Behaviors Among School-Enrolled Young Women in Rural South Africa (HPTN 068)

Overview

Journal AIDS Behav

Specialty Infectious Diseases

Date 2016 Jun 5

PMID 27260180

Citations 8

Authors

Larissa Jennings

Audrey Pettifor

Erica Hamilton

Tiarney D Ritchwood

F Xavier Gomez-Olive

Catherine MacPhail

James Hughes

Amanda Selin

Kathleen Kahn

Affiliations

Soon will be listed here.

Abstract

Individual economic resources may have greater influence on school-enrolled young women's sexual decision-making than household wealth measures. However, few studies have investigated the effects of personal income, employment, and other financial assets on young women's sexual behaviors. Using baseline data from the HIV Prevention Trials Network (HPTN) 068 study, we examined the association of ever having sex and adopting sexually-protective practices with individual-level economic resources among school-enrolled women, aged 13-20 years (n = 2533). Age-adjusted results showed that among all women employment was associated with ever having sex (OR 1.56, 95 % CI 1.28-1.90). Among sexually-experienced women, paid work was associated with changes in partner selection practices (OR 2.38, 95 % CI 1.58-3.58) and periodic sexual abstinence to avoid HIV (OR 1.71, 95 % CI 1.07-2.75). Having money to spend on oneself was associated with reducing the number of sexual partners (OR 1.94, 95 % CI 1.08-3.46), discussing HIV testing (OR 2.15, 95 % CI 1.13-4.06), and discussing condom use (OR 1.99, 95 % CI 1.04-3.80). Having a bank account was associated with condom use (OR 1.49, 95 % CI 1.01-2.19). Economic hardship was positively associated with ever having sex, but not with sexually-protective behaviors. Maximizing women's individual economic resources may complement future prevention initiatives.

Citing Articles

Examining Cash Expenditures and Associated HIV-Related Behaviors Using Financial Diaries in Women Employed by Sex Work in Rural Uganda: Findings from the Kyaterekera Study.

Jennings Mayo-Wilson L, Peterson S, Kiyingi J, Nabunya P, Bahar O, Yang L Int J Environ Res Public Health. 2023; 20(9).

PMID: 37174132 PMC: 10178413. DOI: 10.3390/ijerph20095612.

Women empowerment and sexually transmitted infections: Evidence from Bangladesh demographic and health survey 2014.

Biswas M, Kafi M, Morshed Hemel M, Ahmed M, Khan S PLoS One. 2022; 17(2):e0263958.

PMID: 35171939 PMC: 8849524. DOI: 10.1371/journal.pone.0263958.

Acceptability of a feasibility randomized clinical trial of a microenterprise intervention to reduce sexual risk behaviors and increase employment and HIV preventive practices (EMERGE) in young adults: a mixed methods assessment.

Jennings Mayo-Wilson L, Coleman J, Timbo F, Latkin C, Torres Brown E, Butler A BMC Public Health. 2020; 20(1):1846.

PMID: 33267860 PMC: 7709242. DOI: 10.1186/s12889-020-09904-x.

The Impact of a Conditional Cash Transfer on Multidimensional Deprivation of Young Women: Evidence from South Africa's HTPN 068.

Kilburn K, Ferrone L, Pettifor A, Wagner R, Gomez-Olive F, Kahn K Soc Indic Res. 2020; 151(3):865-895.

PMID: 33029038 PMC: 7508742. DOI: 10.1007/s11205-020-02367-y.

Comparative effectiveness of an economic empowerment program on adolescent economic assets, education and health in a humanitarian setting.

Glass N, Remy M, Jennings Mayo-Wilson L, Kohli A, Sommer M, Turner R BMC Public Health. 2020; 20(1):170.

PMID: 32019539 PMC: 7001195. DOI: 10.1186/s12889-020-8219-6.

References

Mueller T, Gavin L, Oman R, Vesely S, Aspy C, Tolma E . Youth assets and sexual risk behavior: differences between male and female adolescents. Health Educ Behav. 2009; 37(3):343-56. DOI: 10.1177/1090198109344689. View

MacPhail C, Adato M, Kahn K, Selin A, Twine R, Khoza S . Acceptability and feasibility of cash transfers for HIV prevention among adolescent South African women. AIDS Behav. 2013; 17(7):2301-12. PMC: 3744631. DOI: 10.1007/s10461-013-0433-0. View

Luke N . Age and economic asymmetries in the sexual relationships of adolescent girls in sub-Saharan Africa. Stud Fam Plann. 2003; 34(2):67-86. DOI: 10.1111/j.1728-4465.2003.00067.x. View

Schwarcz S, Richards T, Frank H, Wenzel C, Chin Hsu L, Chin C . Identifying barriers to HIV testing: personal and contextual factors associated with late HIV testing. AIDS Care. 2011; 23(7):892-900. DOI: 10.1080/09540121.2010.534436. View

Peralta L, Deeds B, Hipszer S, Ghalib K . Barriers and facilitators to adolescent HIV testing. AIDS Patient Care STDS. 2007; 21(6):400-8. DOI: 10.1089/apc.2006.0112. View

de Walque D, Dow W, Nathan R, Abdul R, Abilahi F, Gong E . Incentivising safe sex: a randomised trial of conditional cash transfers for HIV and sexually transmitted infection prevention in rural Tanzania. BMJ Open. 2012; 2:e000747. PMC: 3330254. DOI: 10.1136/bmjopen-2011-000747. View

Gomez-Olive F, Angotti N, Houle B, Klipstein-Grobusch K, Kabudula C, Menken J . Prevalence of HIV among those 15 and older in rural South Africa. AIDS Care. 2013; 25(9):1122-8. PMC: 3778517. DOI: 10.1080/09540121.2012.750710. View

Katz I, Ybarra M, Wyatt M, Kiwanuka J, Bangsberg D, Ware N . Socio-cultural and economic antecedents of adolescent sexual decision-making and HIV-risk in rural Uganda. AIDS Care. 2012; 25(2):258-64. PMC: 3488357. DOI: 10.1080/09540121.2012.701718. View

Fox A . 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. DOI: 10.1017/S0021932011000745. View

10.

Krishnan S, Dunbar M, Minnis A, Medlin C, Gerdts C, Padian N . Poverty, gender inequities, and women's risk of human immunodeficiency virus/AIDS. Ann N Y Acad Sci. 2007; 1136:101-10. PMC: 2587136. DOI: 10.1196/annals.1425.013. View

11.

Pettifor A, Levandowski B, MacPhail C, Padian N, Cohen M, Rees H . Keep them in school: the importance of education as a protective factor against HIV infection among young South African women. Int J Epidemiol. 2008; 37(6):1266-73. PMC: 2734068. DOI: 10.1093/ije/dyn131. View

12.

Chatterji M, Murray N, London D, Anglewicz P . The factors influencing transactional sex among young men and women in 12 sub-Saharan African countries. Soc Biol. 2007; 52(1-2):56-72. DOI: 10.1080/19485565.2002.9989099. View

13.

Arnold M, Raymond H, Fisher H, McFarland W . Socioeconomic position and HIV risk-relevant behavior among lower-income heterosexuals in San Francisco. AIDS Behav. 2010; 15(2):499-506. PMC: 3032910. DOI: 10.1007/s10461-009-9665-4. View

14.

Stratford D, Mizuno Y, Williams K, Courtenay-Quirk C, OLeary A . Addressing poverty as risk for disease: recommendations from CDC's consultation on microenterprise as HIV prevention. Public Health Rep. 2008; 123(1):9-20. PMC: 2099321. DOI: 10.1177/003335490812300103. View

15.

Blankenship K, Friedman S, Dworkin S, Mantell J . Structural interventions: concepts, challenges and opportunities for research. J Urban Health. 2006; 83(1):59-72. PMC: 1473169. DOI: 10.1007/s11524-005-9007-4. View

16.

Pinkham S, Malinowska-Sempruch K . Women, harm reduction and HIV. Reprod Health Matters. 2008; 16(31):168-81. DOI: 10.1016/S0968-8080(08)31345-7. View

17.

Krueger L, Wood R, Diehr P, Maxwell C . Poverty and HIV seropositivity: the poor are more likely to be infected. AIDS. 1990; 4(8):811-4. View

18.

Dworkin S, Blankenship K . Microfinance and HIV/AIDS prevention: assessing its promise and limitations. AIDS Behav. 2009; 13(3):462-9. PMC: 3770268. DOI: 10.1007/s10461-009-9532-3. View

19.

Pettifor A, MacPhail C, Anderson A, Maman S . 'If I buy the Kellogg's then he should [buy] the milk': young women's perspectives on relationship dynamics, gender power and HIV risk in Johannesburg, South Africa. Cult Health Sex. 2012; 14(5):477-90. PMC: 3570821. DOI: 10.1080/13691058.2012.667575. View

20.

Pettifor A, Rees H, Kleinschmidt I, Steffenson A, MacPhail C, Hlongwa-Madikizela L . Young people's sexual health in South Africa: HIV prevalence and sexual behaviors from a nationally representative household survey. AIDS. 2005; 19(14):1525-34. DOI: 10.1097/01.aids.0000183129.16830.06. View