HIV Risks in Sexual Networks of Heterosexual Men in South Africa

Nonzwakazi P Ntombela,Ayesha Bm Kharsany,Desmond Kuupiel,Tivani P Mashamba-Thompson,Andile N Mtshali

doi:10.5539/gjhs.v11n13p146

Nonzwakazi P Ntombela, Ayesha Bm Kharsany + Show 3 more

Open Access

https://doi.org/10.5539/gjhs.v11n13p146

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Abstract

BACKGROUND: The interaction of HIV risks in sexual networks remains unclear in South Africa. We provide an overview of the dynamics of HIV risks in South African men through a systematic scoping review.  METHODS &amp; ANALYSIS: Literature searches were conducted on seven online databases. Two reviewers independently screened articles against the inclusion criteria and performed a Kappa coefficient test to evaluate the degree of agreement on article selection. Thematic content analysis and a Mixed Method Appraisal Tool version 2018 were used to present the narrative account of the outcomes and to assess the risk of bias on included studies.  RESULTS: Of the 1356 records identified, six studies reported on the dynamics of HIV infection in heterosexual men in sexual networks. All studies that were included were published between 2006 and 2016. The participants were aged 13 years and above and comprised of sero-discordant couples, HIV patients, and male and female in the general population. These studies were conducted in multiple diverse regions including South Africa, Senegal, Uganda, Malawi, Kenya, Tanzania, Botswana and Zambia. Evidence showed that age and sexual partnerships were most commonly identified attributes to either HIV infection and/or transmission risks in men. While other biological and behavioral data were reported, the results were not specific to men.   DISCUSSION: The impact of age and sexual partnerships are poorly understood and the data available limit inferences to South African men. Limited empiric evidence of HIV risk among men impacts on the design, development and tailoring of HIV prevention interventions to alter the trajectory.

Highlights

South Africa is home to the majority of HIV cases globally (Joint United Nations Programme on HIV/AIDS [UNAIDS], 2014) and the incidence has remained unchanged over the past decades (Iwuji et al, 2018)
We provide an overview of the dynamics of HIV risks in South African men through a systematic scoping review
Of the 1356 records identified, six studies reported on the dynamics of HIV infection in heterosexual men in sexual networks

Summary

Introduction

South Africa is home to the majority of HIV cases globally (Joint United Nations Programme on HIV/AIDS [UNAIDS], 2014) and the incidence has remained unchanged over the past decades (Iwuji et al, 2018). Traditional epidemiological studies focusing primarily on individual-level risk suggest major risks in men. Majority of men remain unaware about their HIV status have slow and poor linkage to care (Iwuji et al, 2018; Shisana et al, 2014; Takuva, Brown, Pillay, Delpech, & Puren, 2017), and have higher probability of progression to AIDS-defining illness compared to women (Huerga et al, 2018; Johnson, Rehle, Jooste, & Bekker, 2015). It has been argued that majority of men have low HIV risk perception, and this impacts their health-seeking behaviours to reduce risks of HIV acquisition and faster progression of HIV towards AIDS-defining illness (Shisana et al, 2014). We provide an overview of the dynamics of HIV risks in South African men through a systematic scoping review

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