Accuracy and determinants of perceived HIV risk among young women in South Africa

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dc.contributor.authorVenkataramani, Atheendar S
dc.date.accessioned2021-10-08T06:54:52Z
dc.date.available2021-10-08T06:54:52Z
dc.date.issued2018
dc.description.abstractAbstract Background HIV risk perceptions are a key determinant of HIV testing. The success of efforts to achieve an AIDS-free generation – including reaching the UNAIDS 90–90-90 target – thus depends critically on the content of these perceptions. We examined the accuracy of HIV-risk perceptions and their correlates among young black women in South Africa, a group with one of the highest HIV incidence rates worldwide. Methods We used individual-level longitudinal data from the Cape Area Panel Study (CAPS) from 2005 to 2009 on black African women (20–30 years old in 2009) to assess the association between perceived HIV-risk in 2005 and the probability of testing HIV-positive four years later. We then estimated multivariable logistic regressions using cross-sectional data from the 2009 CAPS wave to assess the relationship between risk perceptions and a wide range of demographic, sexual behaviour and psychosocial covariates of perceived HIV-risk. Results We found that the proportion testing HIV-positive in 2009 was almost identical across perceived risk categories in 2005 (no, small, moderate, great) (χ 2 = 1.43, p = 0.85). Consistent with epidemiologic risk factors, the likelihood of reporting moderate or great HIV-risk perceptions was associated with condom-use (aOR: 0.57; 95% CI: 0.36, 0.89; p < 0.01); having ≥3 lifetime partners (aOR: 2.38, 95% CI: 1.53, 3.73; p < 0.01); knowledge of one’s partner’s HIV status (aOR: 0.67; 95% CI: 0.43, 1.07; p = 0.09); and being in an age-disparate partnerships (aOR: 1.73; 95% CI: 1.09, 2.76; p = 0.02). However, the likelihood of reporting moderate or great self-perceived risk did not vary with sexually transmitted disease history and respondent age, both strong predictors of HIV risk in the study setting. Risk perceptions were associated with stigmatising attitudes (aOR: 0.53; 95% CI: 0.26, 1.09; p = 0.09); prior HIV testing (aOR: 0.21; 95% CI: 0.13, 0.35; p < 0.01); and having heard that male circumcision is protective (aOR: 0.38; 95% CI: 0.22, 0.64; p < 0.01). Conclusions Results indicate that HIV-risk perceptions are inaccurate. Our findings suggest that this inaccuracy stems from HIV-risk perceptions being driven by an incomplete understanding of epidemiological risk and being influenced by a range of psycho-social factors not directly related to sexual behaviour. Consequently, new interventions are needed to align perceived and actual HIV risk.
dc.identifier.apacitationVenkataramani, A. S. (2018). Accuracy and determinants of perceived HIV risk among young women in South Africa. <i>BMC Public Health</i>, 18(1), 174 - 177. http://hdl.handle.net/11427/34362en_ZA
dc.identifier.chicagocitationVenkataramani, Atheendar S "Accuracy and determinants of perceived HIV risk among young women in South Africa." <i>BMC Public Health</i> 18, 1. (2018): 174 - 177. http://hdl.handle.net/11427/34362en_ZA
dc.identifier.citationVenkataramani, A.S. 2018. Accuracy and determinants of perceived HIV risk among young women in South Africa. <i>BMC Public Health.</i> 18(1):174 - 177. http://hdl.handle.net/11427/34362en_ZA
dc.identifier.issn1471-2458
dc.identifier.ris TY - Journal Article AU - Venkataramani, Atheendar S AB - Abstract Background HIV risk perceptions are a key determinant of HIV testing. The success of efforts to achieve an AIDS-free generation – including reaching the UNAIDS 90–90-90 target – thus depends critically on the content of these perceptions. We examined the accuracy of HIV-risk perceptions and their correlates among young black women in South Africa, a group with one of the highest HIV incidence rates worldwide. Methods We used individual-level longitudinal data from the Cape Area Panel Study (CAPS) from 2005 to 2009 on black African women (20–30 years old in 2009) to assess the association between perceived HIV-risk in 2005 and the probability of testing HIV-positive four years later. We then estimated multivariable logistic regressions using cross-sectional data from the 2009 CAPS wave to assess the relationship between risk perceptions and a wide range of demographic, sexual behaviour and psychosocial covariates of perceived HIV-risk. Results We found that the proportion testing HIV-positive in 2009 was almost identical across perceived risk categories in 2005 (no, small, moderate, great) (χ 2 = 1.43, p = 0.85). Consistent with epidemiologic risk factors, the likelihood of reporting moderate or great HIV-risk perceptions was associated with condom-use (aOR: 0.57; 95% CI: 0.36, 0.89; p < 0.01); having ≥3 lifetime partners (aOR: 2.38, 95% CI: 1.53, 3.73; p < 0.01); knowledge of one’s partner’s HIV status (aOR: 0.67; 95% CI: 0.43, 1.07; p = 0.09); and being in an age-disparate partnerships (aOR: 1.73; 95% CI: 1.09, 2.76; p = 0.02). However, the likelihood of reporting moderate or great self-perceived risk did not vary with sexually transmitted disease history and respondent age, both strong predictors of HIV risk in the study setting. Risk perceptions were associated with stigmatising attitudes (aOR: 0.53; 95% CI: 0.26, 1.09; p = 0.09); prior HIV testing (aOR: 0.21; 95% CI: 0.13, 0.35; p < 0.01); and having heard that male circumcision is protective (aOR: 0.38; 95% CI: 0.22, 0.64; p < 0.01). Conclusions Results indicate that HIV-risk perceptions are inaccurate. Our findings suggest that this inaccuracy stems from HIV-risk perceptions being driven by an incomplete understanding of epidemiological risk and being influenced by a range of psycho-social factors not directly related to sexual behaviour. Consequently, new interventions are needed to align perceived and actual HIV risk. DA - 2018 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Public Health LK - https://open.uct.ac.za PY - 2018 SM - 1471-2458 T1 - Accuracy and determinants of perceived HIV risk among young women in South Africa TI - Accuracy and determinants of perceived HIV risk among young women in South Africa UR - http://hdl.handle.net/11427/34362 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34362
dc.identifier.vancouvercitationVenkataramani AS. Accuracy and determinants of perceived HIV risk among young women in South Africa. BMC Public Health. 2018;18(1):174 - 177. http://hdl.handle.net/11427/34362.en_ZA
dc.language.isoeng
dc.publisher.departmentSouthern Africa Labour and Development Research Unit (SALDRU)
dc.publisher.facultyFaculty of Commerce
dc.sourceBMC Public Health
dc.source.journalissue1
dc.source.journalvolume18
dc.source.pagination174 - 177
dc.source.urihttps://dx.doi.org/10.1186/s12889-017-4593-0
dc.subject.otherRisk perceptions
dc.subject.otherSouth Africa
dc.subject.otherHIV testing
dc.subject.otherSexual behaviour
dc.subject.otherWomen
dc.subject.otherStigma
dc.titleAccuracy and determinants of perceived HIV risk among young women in South Africa
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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