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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Assessing the effect of HIV counselling and testing on HIV acquisition among South African youth
AIDS, Volume 27, No. 17, Year 2013
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Description
Objective: Youth aged 15-24 years in sub-Saharan Africa are at a high risk for HIV acquisition and urgently need HIV prevention interventions. HIV counselling and testing (HCT) is designed to promote HIV prevention. However the impact of HCT on HIV acquisition has never been assessed among youth. We assess the impact of HCT on HIV acquisition among South African youth. Design: Data came from an annual HIV survey for persons aged 15 years and over, nested within a socio-demographic household surveillance in a geographically defined area of KwaZulu-Natal. Within this population, we used data from 2006 to 2011 to construct a cohort of HIV-uninfected youth aged 15-24 years. Methods: We compared youth who reported knowing their HIV status from HCT with those who reported not knowing their HIV status for time to HIV seroconversion using time-varying marginal structural Cox proportional hazards models. Results: The cohort included 3959 HIV-uninfected youth, of whom 1167 (29%) reported HCT at baseline and an additional 1064 (27%) reported HCT during follow up. Youth experienced 248 seroconversions over 8536 person-years, an incidence rate of 2.91 per 100 person-years [95% confidence interval (CI) 2.56-3.28]. In crude analysis, HCT was not associated with HIV incidence (hazard ratio 1.02, 95% CI 0.79-1.31], but in marginal structural models weighted for risk factors, HCT was protective (hazard ratio 0.59, 95% CI 0.45-0.78). Conclusion: In this high-risk population, after accounting for differences in underlying HIV acquisition risk, HCT was associated with lower HIV incidence. HCT scale-up may have prevention benefits for HIV-uninfected youth. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Authors & Co-Authors
Rosenberg, Nora Ellen
United States, Chapel Hill
The University of North Carolina at Chapel Hill
South Africa, Durban
University of Kwazulu-natal
Westreich, Daniel
United States, Chapel Hill
The University of North Carolina at Chapel Hill
United States, Durham
Duke University
Bärnighausen, Till Winfried
South Africa, Durban
University of Kwazulu-natal
United States, Boston
Harvard T.h. Chan School of Public Health
Miller, William C.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
United States, New Haven
School of Medicine
Behets, Frieda M.T.F.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
United States, New Haven
School of Medicine
Maman, Suzanne
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Newell, Marie Louise
South Africa, Durban
University of Kwazulu-natal
United Kingdom, Southampton
University of Southampton
Pettifor, Audrey E.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Statistics
Citations: 42
Authors: 8
Affiliations: 6
Identifiers
Doi:
10.1097/01.aids.0000432454.68357.6a
e-ISSN:
14735571
Research Areas
Environmental
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Quantitative