Browsing by Author "Colebunders, Robert"

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    Open Access
    HIV prevalence by race co-varies closely with concurrency and number of sex partners in South Africa
    (Public Library of Science, 2013) Kenyon, Chris; Buyze, Jozefien; Colebunders, Robert
    BACKGROUND: HIV prevalence differs by more than an order of magnitude between South Africa's racial groups. Comparing the sexual behaviors and other risk factors for HIV transmission between the different races may shed light on the determinants of South Africa's generalized HIV epidemic. METHODS: Five nationally representative and one city-representative population-based surveys of sexual behavior were used to assess the extent to which various risk factors co-varied with HIV prevalence by race in South Africa. RESULTS: In 2004, the prevalence of HIV was 0.5%, 1%, 3.2% and 19.9% in 15-49 year old whites, Indians, coloureds and blacks respectively. The risk factors which co-varied with HIV prevalence by race in the six surveys were age of sexual debut (in five out of five surveys for men and three out of six surveys for women), age gap (zero surveys in men and three in women), mean number of sex partners in the previous year (five surveys in men and three in women) and concurrent partnerships (five surveys in men and one in women). Condom usage and circumcision were both more prevalent in the high HIV prevalence groups. The reported prevalence of concurrency was 6 to 17 times higher in the black as opposed to the white men in the five surveys. CONCLUSIONS: The differences in sexual behavior in general, and the prevalence of concurrency and the number of sexual partners in particular, offer a plausible and parsimonious cause to explain a part of the differing prevalences of HIV between South Africa's racial groups.
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    Open Access
    Migration intensity has no effect on peak HIV prevalence: an ecological study
    (BioMed Central Ltd, 2014) Kenyon, Chris; Colebunders, Robert; Voeten, Helene; Lurie, Mark
    BACKGROUND:Correctly identifying the determinants of generalized HIV epidemics is crucial to bringing down ongoing high HIV incidence in these countries. High rates of migration are believed to be an important determinant of HIV prevalence. This study has two aims. Firstly, it evaluates the ecological association between levels of internal and international migration and national peak HIV prevalence using thirteen variables from a variety of sources to capture various aspects of internal and international migration intensity. Secondly, it examines the relationship between circular migration and HIV at an individual and population-level in South Africa. METHODS: Linear regression was used to analyze the association between the various measures of migration intensity and peak national HIV prevalence for 141 countries and HIV prevalence by province and ethnic group in South Africa. RESULTS: No evidence of a positive ecological association between national migration intensity and HIV prevalence was found. This remained the case when the analyses were limited to the countries of sub-Saharan Africa. On the whole, countries with generalized HIV epidemics had lower rates of internal and external migration. Likewise, no association was found between migration and HIV positivity at an individual or group-level in South Africa. CONCLUSION: These results do not support the thesis that migration measured at the country level plays a significant role in determining peak HIV prevalence.
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    What is the optimal first line antiretroviral therapy in resource-limited settings?
    (Public Library of Science, 2012) Kenyon, Chris; Colebunders, Robert
    A perspective by Chris Kenyon and Robert Colebunders discusses policy implications for use of first line antiretroviral therapies in resource-limited settings, emerging from a new research study conducted by Campbell and colleagues.