Concurrent sexual partnerships and HIV prevalence in five urban communities of sub-Saharan Africa

Abstract Background In sub-Saharan Africa HIV transmission is a major challenge in adolescents, especially among girls and those living in urban settings. Major international efforts have aimed at reducing sexual transmission. This analysis aims to assess the trends in HIV prevalence by gender in adolescents, as well as urban-rural disparities. Methods HIV prevalence data were obtained for 30 countries with a national survey since 2010 and for 23 countries with one survey circa 2005 and a recent survey circa 2015. Countries were grouped into 2% or higher and lower than 2% HIV prevalence among girls 15–19 years in the first survey. Country medians and average annual rates of changes were used to summarize the trends. Data on HIV incidence at ages 15–24 and prevalence at 5–9 and 10–14 years were reviewed from 11 recent national surveys. Trends in urban-rural disparities in HIV prevalence and selected indicators of sexual and HIV testing behaviours were assessed for females and males 15–24 years, using the same surveys. Results HIV prevalence among girls 15–19 years declined in the higher HIV prevalence group from 5.7–2.6% during 2005–2015, corresponding with an average annual rate of reduction of 6.5% per year. Among boys, the median HIV prevalence declined from 2.1–1.2% in the higher prevalence group. Smaller changes were observed in the lower prevalence country group where median HIV prevalence among girls decreased from 0.7–0.4% (average annual rate of reduction 5.9%). Girl – boy differences at 10–14 years were small with a country median HIV of 1.0% and 1.3%, respectively. Urban females and males 15–24 had at least 1.5 times higher HIV prevalence than their rural counterparts, and all experienced similar declines during 2005–2015. Condom use and HIV testing increased among adolescents in both higher and lower prevalence countries, but indicators of sexual activity showed little change over time. Conclusions HIV prevalence declined in almost all countries during the last decade, in both urban and rural settings, for both sexes. The urban-rural gap persisted and HIV transmission to girls, but not boys, is still a major challenge in eastern and southern African countries.

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HIV prevalence and trends in sub-Saharan Africa: no decline and large subregional differences

The Lancet ◽

10.1016/s0140-6736(04)16587-2 ◽

2004 ◽

Vol 364 (9428) ◽

pp. 35-40 ◽

Cited By ~ 76

Author(s):

Emil Asamoah-Odei ◽

Jesus M Garcia Calleja ◽

J Ties Boerma

Keyword(s):

Hiv Prevalence ◽

Sub Saharan Africa ◽

Sub Saharan

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Adjusting ante-natal clinic data for improved estimates of HIV prevalence among women in sub-Saharan Africa

AIDS ◽

10.1097/00002030-200012010-00014 ◽

2000 ◽

Vol 14 (17) ◽

pp. 2741-2750 ◽

Cited By ~ 43

Author(s):

Basia W. Zaba ◽

Lucy M. Carpenter ◽

J. Ties Boerma ◽

Simon Gregson ◽

Jessica Nakiyingi ◽

...

Keyword(s):

Hiv Prevalence ◽

Sub Saharan Africa ◽

Sub Saharan

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Men’s Economic Status and Marriage Timing in Rural and Semi-Urban Malawi

Social Forces ◽

10.1093/sf/soaa092 ◽

2020 ◽

Author(s):

Isabel Pike

Keyword(s):

Urban Communities ◽

Survey Data ◽

Economic Status ◽

Family Characteristics ◽

Sub Saharan Africa ◽

Urban Centers ◽

Marriage Timing ◽

Household Level ◽

Sub Saharan ◽

The Individual

Abstract In recent decades, qualitative research from across sub-Saharan Africa has shown how young men are often unable to marry because they lack wealth and a stable livelihood. With survey data, researchers have begun to study how men’s economic circumstances are related to when they marry in the continent’s capitals and larger urban centers. However, our understanding of these dynamics outside of large cities remains limited. Drawing on longitudinal survey data, this paper examines how men’s economic standing, both at the individual and household level, relates to their marriage timing in rural and semi-urban communities in the Salima district of Malawi. The findings show that men who have higher earnings, work in agriculture, and come from a household that sold cash crops were more likely to marry. In contrast, students as well as men from households owning a large amount of land were substantially less likely to marry. Additionally, men living in the semi-urban communities were around half as likely to marry as their rural counterparts. This negative association is largely explained by the greater proportion of men who are students in towns and trading centers and also the relatively less agricultural nature of these communities. These findings show the value of considering both individual and family characteristics in studies of marriage timing and also suggest that as sub-Saharan Africa urbanizes, the age of marriage for men will likely rise.

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