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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Early adolescent pregnancy increases risk of incident HIV infection in the eastern cape, south africa: A longitudinal study
Journal of the International AIDS Society, Volume 17, Article 18585, Year 2014
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Description
Introduction: Adolescents having unprotected heterosexual intercourse are at risk of HIV infection and unwanted pregnancy. However, there is little evidence to indicate whether pregnancy in early adolescence increases the risk of subsequent HIV infection. In this paper, we tested the hypothesis that adolescent pregnancy (aged 15 or younger) increases the risk of incident HIV infection in young South African women. Methods: We assessed 1099 HIV-negative women, aged 15-26 years, who were volunteer participants in a cluster-randomized, controlled HIV prevention trial in the predominantly rural Eastern Cape province of South Africa. All of these young women had at least one additional HIV test over two years of follow-up. Outcomes were HIV incidence rates per 100 person years and HIV incidence rate ratios (IRRs) estimated by Poisson multivariate models. Three pregnancy categories were created for the Poisson model: early adolescent pregnancy (a first pregnancy at age 15 years or younger); later adolescent pregnancy (a first pregnancy at age 16 to 19 years); and women who did not report an adolescent pregnancy. Models were adjusted for study design, age, education, time since first sexual experience, socio-economic status, childhood trauma and herpes simplex virus type 2 infection. Results: HIV incidence rates were 6.0 per 100 person years over two years of follow-up. The adjusted IRR was 3.02 (95% CI 1.50-6.09) for a pregnancy occurring at age 15 or younger. Women with pregnancies occurring between 16 and 19 years of age did not have a higher incidence of HIV (IRR 1.08; 95% CI 0.64-1.84). Early adolescent pregnancies were associated with higher partner numbers and a greater age difference with partners. Conclusions: Early adolescent pregnancies increase the incidence of HIV among South African women. The higher risk is associated with sexual risk behaviours such as higher partner numbers and a greater age difference with partners rather than a biological explanation of hormonal changes during pregnancy. © 2014 Christofides NJ et al; licensee International AIDS Society.
Authors & Co-Authors
Christofides, Nicola Joan
South Africa, Johannesburg
Wits School of Public Health
Jewkes, R. K.
South Africa, Johannesburg
Wits School of Public Health
South Africa, Pretoria
South African Medical Services
Dunkle, Kristin L.
United States, Atlanta
Rollins School of Public Health
Nduna, Mzikazi
South Africa, Johannesburg
University of the Witwatersrand
Shai, P. Nwabisa
South Africa, Johannesburg
Wits School of Public Health
South Africa, Pretoria
South African Medical Services
Sterk, Claire E.
United States, Atlanta
Rollins School of Public Health
Statistics
Citations: 100
Authors: 6
Affiliations: 4
Identifiers
Doi:
10.7448/IAS.17.1.18585
e-ISSN:
17582652
Research Areas
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Randomised Control Trial
Cohort Study
Study Approach
Quantitative
Study Locations
South Africa
Participants Gender
Female