Browsing by Subject "South African men"

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    Open Access
    Exploring the relationship between sexual risk behaviours and HIV Status awareness among men in South Africa: analysis of data from the 2017 South African National house-based HIV prevalence, incidence and behaviour survey
    (2025) Nhlabatsi, Zanele; Phillips, Tamsin; Moyo, Sizulu
    South Africa has one of the highest HIV prevalence rates globally, with men being a key population at risk due to risky sexual behaviours and lower HIV status awareness compared to women. This study explored the relationships between sexual risk behaviours and HIV status awareness among 1,630 sexually active South African men (≥15 years, median age 34 years, interquartile range 24-44) using data from the 2017 South African National House-based HIV Prevalence, Incidence, and Behaviour Surveys (SABSSMV). Overall, 13.5% of men self-reported living with HIV (srHIV+) and there was high concordance between self-reported and laboratory confirmed HIV status with 92.0% (95% confidence interval [CI] 84.1% - 96.1%) and 88.0% (95% CI 85.5% - 90.2%); p<0.001, of men srHIV+ and those self-reporting not living with HIV (srHIV-) being laboratory confirmed, respectively. In total, 68.3% (95% CI 64.6% - 71.8%) of men reported casual sexual partners ( 48.2% [95% CI 39.0% - 57.5%] among men srHIV+ vs. 71.4% [95% CI 67.4% - 75.2%] among men srHIV-); p<0.001, 4.9% (95% CI 3.6% - 6.7%) reported ≥2 sexual partners (2.6% [95% CI 1.1% - 6.2%] vs. 5.3% [95% CI 3.8% - 7.4%]); p = 0.116, 26.5% (95% CI 23.4% - 29.9%) reported inconsistent condom use at last sex with all partners in the past year (23.3% [16.0% - 32.7%] vs. 27.0% [95% CI 23.6% - 30.8%]); p = 0.430, and 14.2% (95% CI 11.8% - 17.1%) reported alcohol use at last sex (16.9% [95% CI 10.9% - 25.1%] vs. 13.8% [11.3% - 16.9%]); p = 0.431, with values in brackets showing the proportion among those (srHIV+) versus (srHIV-), respectively. In logistic regression models, men (srHIV+) were less likely to report engaging in casual sex compared to men (srHIV-) ( (adjusted odds ratio 0.51 95% CI: 0.27–0.97). Variations in sexual risk behaviours were observed by demographic characteristics, and age appeared to modify the association between reported HIV status and some risk behaviours. The findings highlight the impact of HIV status on risky sexual behaviour, emphasizing the need for comprehensive HIV testing and counselling (HTC), safe sex education, and integrated behavioural and structural approaches in healthcare. Tailored interventions such as age-specific messaging, accessible educational content, ensuring condom and PrEP availability, youth-friendly tech-based solutions like online counselling or mobile apps, and public campaigns promoting safe sexual practices, will be essential to address the unique needs of different age groups, education levels, HIV statuses, and geographic settings.
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    Open Access
    Identifying genetic biomarkers for diagnosis of prostate cancer in South African men
    (2020) Salukazana, Samkele Azola; Kaestner, Lisa; Wium, Mariet; Zerbini, Luiz
    Background and Aim: Prostate cancer (PCa) is the leading cancer diagnosis amongst South African men. The incidence of PCa is 68.0 per 100 000 Age Standardized Rate (ASR) and the mortality rates are 27.9 per 100 000 ASR; Globocan 2018. Diagnosis of PCa is based on a combination of digital rectal examination, prostate-specific antigen (PSA) and histology. Several biomarkers have been used to increase the sensitivity and specificity of PSA in distinguishing patients with PCa from those with benign prostatic hyperplasia (BPH). These include fractionated PSA, free/total PSA ratio, −2proPSA, prostate cancer antigen 3 and prostate health index amongst others. Biomarkers are needed to differentiate BPH from PCa due to a lack of specificity of these markers with PSA levels above 4.0 ng/ml. The aim of this study is to investigate gene expression patterns of South African men in 9 PCa and 10 BPH patients in order to distinguish between the two groups. Methods: Ethical approval was obtained (HREC 454/2012). Patients scheduled for transurethral resection of the prostate were recruited from the Western Cape. RNA was extracted from prostate tissue using the AllPrep DNA/RNA/miRNA Universal Kit (Qiagen). Complementary DNA was synthesized from RNA using the SuperScript IV VILO Master Mix (Thermo Fischer Scientific). Gene expression was analyzed with the Human Prostate Cancer RT2 Profiler PCR Array and SYBR Green Master Mix. Data were analyzed with the GeneGlobe RT2 and miScript PCR Array Data Analysis Centre from Qiagen. Results: The cohort included patients from different ethnic groups namely, Caucasians, Mixedand African ancestry. The PCa group has an age range from 56 to 75 years (mean 65) while the BPH group was slight older ranging from 60 to 76 years (mean 68). PSA levels range from 24 to 5000 ng/ml (mean 1252 ng/ml, median 185) for the PCa group and 11 to 58 ng/mL (mean 25 ng/ml, median 22) for the BPH group. The following genes were downregulated 2-fold in the PCa group with p values s <0.05; IGF1, PTEN, GSTP1, SOCS3, EGR3, GPX3, TIMP3, ZNF185, DKK3, PTGS2, FOXO1, ARNTL, TNFRSF10D, CCND1, and DLC1, upregulated genes included; CDH1, MKI67, TMPRSS2, ERG, CDKN2A, FASN, and AR but were not statistically significant. At a fold change threshold of 1.5, the following additional genes were downregulated in the PCa group with p values <0.05; DAXX, EGFR, RASSF1, SOX4, and TIMP2, upregulated genes were ACACA, AR, CDKN2A, ERG and FASN but were also not statistically significant. The study shows similarly differentially expressed genes as seen in international studies. Of note PTEN, MKI67 and FASN which are associated with poor prognosis. EGR3 was downregulated in our study and this has been associated aggressive disease and predict relapse after PCa treatment. This could explain the high mortality demonstrated in South African epidemiological studies. Conclusion: We identified a group of differentially expressed genes that have potential in distinguishing PCa and BPH patients with PSA values above 10 ng/ml. A larger population study is needed to further evaluate the clinical significance of our findings.
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    Transactional relationships and sex with a woman in prostitution: prevalence and patterns in a representative sample of South African men
    (BioMed Central Ltd, 2012) Jewkes, Rachel; Morrell, Robert; Sikweyiya, Yandisa; Dunkle, Kristin; Penn-Kekana, Loveday
    BACKGROUND: Sex motivated by economic exchange is a public health concern as a driver of the Sub-Saharan African HIV epidemic. We describe patterns of engagement in transactional sexual relationships and sex with women in prostitution of South African men, and suggest interpretations that advance our understanding of the phenomenon. METHODS: Cross-sectional study with a randomly-selected sample of 1645 sexually active men aged 18-49years who completed interviews in a household study and were asked whether they had had sex with a woman in prostitution, or had had a relationship or sex they took to be motivated by the expectation of material gain (transactional sex). RESULTS: 18% of men had ever had sex with a woman in prostitution, 66% at least one type of transactional sexual relationship, only 30% of men had done neither. Most men had had a transactional relationship/sex with a main partner (58% of all men), 42% with a concurrent partner (or makhwapheni) and 44% with a once off partner, and there was almost no difference in reports of what was provided to women of different partner types. The majority of men distinguished the two types of sexual relationships and even among men who had once-off transactional sex and gave cash (n=314), few (34%) reported that they had had sex with a 'prostitute'. Transactional sex was more common among men aged 25-34years, less educated men and low income earners rather than those with none or higher income. Having had sex with a woman in prostitution varied little between social and demographic categories, but was less common among the unwaged or very low earners. CONCLUSIONS: The notion of 'transactional sex' developed through research with women does not translate easily to men. Many perceive expectations that they fulfil a provider role, with quid pro quo entitlement to sex. Men distinguished these circumstances of sex from having sex with a woman in prostitution. Whilst there may be similarities, when viewed relationally, these are quite distinct practices. Conflating them is sociologically inappropriate. Efforts to work with men to reduce transactional sex should focus on addressing sexual entitlement and promoting gender inequity.