Material deprivation and sexual risk nexus among young people in urban disadvantaged settings in Malawi and South Africa

Objective: Understanding how context-specific measures of urban disadvantage are associated with sexual risk is critical to the refinement of effective HIV prevention interventions in urban disadvantaged settings in sub-Saharan Africa . This study describes how a mixed methods research design was used to get a more nuanced understanding of young people’s experience of material deprivation and their motivation for sexual risk-taking in urban disadvantaged settings. The study involved secondary analysis of data (n=560) from South Africa, primary qualitative study with 60 young people and household survey (n = 1,071) in Malawi. Legitimation strategies were used to identify inferences from the findings. Material deprivation characteristics that explained the most variance in sexual risk were determined by using logged coefficients multiplied by their standard deviations. Results: In South Africa, financial difficulty (0.16 = (log 2.11)*(0.50)) exerted the strongest effects on sexual risk followed by deprivation (0.10 = (log 1.43)*(0.66)) among young women, while for young men, material deprivation (0.04 = (log 1.20)*(0.50)) showed significant effects on sexual risk-taking. However in Malawi, material deprivation (0.08 = (log 1.37)*(0.58)) and unemployment (0.12 = (log 1.77)*(0.50)) were the most influential indicators of deprivation associated with coercive sex among young women and young men respectively.