Abstract
BackgroundAdolescents are at increased risk of HIV infection compared to other age groups. There is an urgent need for strategic information that will inform programmes to reduce risk and vulnerability to HIV and reverse the pattern of increasing HIV infection as they transition to adulthood. This paper analysed trends and factors associated with HIV prevalence among adolescents in South Africa using the national HIV population-based household surveys conducted in 2008, 2012 and 2017.MethodsAll three surveys used a multistage cross-sectional design. A trend analysis was conducted to assess the differences in HIV prevalence and covariates overtime using P-trend Chi-squared statistic. Univariate and multivariate logistic regression models were used to determine factors associated with HIV prevalence.ResultsOverall there was a significant increase in HIV prevalence among adolescents aged 12–19 years from 3.0% (n = 2892) in 2008 to 3.2% (n = 4829) in 2012 and 4.1% (n = 3937) in 2017 (p = 0.031). The odds of being HIV positive among adolescents aged 12–19 years was significantly higher among females [AOR = 2.24; 95% CI (1.73–2.91); p < 0.001] than males, those residing in KwaZulu-Natal province [AOR = 2.01; 95% CI (1.-3.99); p = 0.027] than Northern Cape, and those who did not attend an educational institution and were unemployed [AOR = 2.66; 95% CI (1.91–3.67); p < 0.001] compared to those attending an educational institution. The odds were significantly lower among Whites [AOR = 0.29; 95% CI (0.09–0.93); p = 0.037], Coloureds [AOR = 0.21; 95% CI (0.11–0.37); p ≤ 0.001] and Indian/Asian [AOR = 0.08; 95% CI (0.02–0.34); p = 0.001] population groups than Black Africans.ConclusionThe observed increasing trend and gender disparities in HIV prevalence suggests an urgent need for age appropriate and gender specific HIV interventions tailored and targeted at identified drivers of HIV infection among adolescents.
Highlights
Adolescents represent a growing number of people living with HIV worldwide
Survey design and data collection This secondary analysis is based on data collected using a multi-stage cross-sectional design from the three nationally representative household-based South African National HIV Prevalence, Incidence, Behaviour and Communication surveys completed in South Africa since 2008, 2012 and 2017 [14,15,16]
In the older adolescent age group of 15–19 year olds, HIV prevalence decreased from 4.4% in 2008 to 3.2% in 2012 and increased to 6.5% in 2017
Summary
Adolescents represent a growing number of people living with HIV worldwide. In 2019, about 1.7 million (1.1 million-2.4 million) adolescents between the ages of 10Mabaso et al AIDS Research and Therapy (2021) 18:97 and 19 were living with HIV worldwide [1]. Adolescents represent a growing number of people living with HIV worldwide. 170,000 (53,000–340,000) adolescents between the ages of 10 and 19 were newly infected with HIV in 2019. Adolescents are highly vulnerable to HIV acquisition than adult because of the transition stage of their development and the need to adapt to the rapid biological, physical and structural changes in their lives [2]. Many young adolescents living with HIV acquired the infection perinatally (during pregnancy, birth or breastfeeding) where mothers were not enrolled in prevention of mother-to-child transmission (PMTCT) programmes [2, 3]. Adolescents are at increased risk of HIV infection compared to other age groups. This paper analysed trends and factors associated with HIV prevalence among adolescents in South Africa using the national HIV population-based household surveys conducted in 2008, 2012 and 2017
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