This study, a secondary analysis of the HPTN 068 randomized control trial, aimed to quantify the association of father and male presence with HIV incidence and first pregnancy among 2533 school-going adolescent girls and young women (AGYW) in rural South Africa participating in the trial between March 2011 and April 2017. Participants’ ages ranged from 13–20 years at study enrollment and 17–25 at the post-intervention visit. HIV and pregnancy incidence rates were calculated for each level of the exposure variables using Poisson regression, adjusted for age using restricted quadratic spline variables, and, in the case of pregnancy, also adjusted for whether the household received a social grant. Our study found that AGYW whose fathers were deceased and adult males were absent from the household were most at risk for incidence of first pregnancy and HIV (pregnancy: aIRR = 1.30, Wald 95% CI 1.05, 1.61, Wald chi-square p = 0.016; HIV: aIRR = 1.27, Wald 95% CI 0.84, 1.91, Wald chi-square p = 0.263) as compared to AGYW whose biological fathers resided with them. For AGYW whose fathers were deceased, having other adult males present as household members seemed to attenuate the incidence (pregnancy: aIRR = 0.92, Wald 95% CI 0.74, 1.15, Wald chi-square p = 0.462; HIV: aIRR = 0.90, Wald 95% CI 0.58, 1.39, Wald chi-square p = 0.623) such that it was similar, and therefore not statistically significantly different, to AGYW whose fathers were present in the household.

本研究是 HPTN 068 随机对照试验的二次分析，旨在量化参与研究的南非农村 2533 名在校少女和年轻女性 (AGYW) 中父亲和男性的存在与艾滋病毒发病率和首次怀孕之间的关系。该试验于 2011 年 3 月至 2017 年 4 月期间进行。参与者的年龄在研究登记时为 13-20 岁，在干预后访视时为 17-25 岁。使用泊松回归计算每个暴露变量水平的艾滋病毒和怀孕发病率，使用限制二次样条变量对年龄进行调整，并且在怀孕的情况下，还根据家庭是否获得社会补助金进行调整。我们的研究发现，父亲已故且成年男性不在家庭中的 AGYW 首次怀孕和 HIV 发生的风险最高（怀孕：aIRR = 1.30，Wald 95% CI 1.05、1.61，Wald 卡方 p = 0.016 ；HIV：aIRR = 1.27，Wald 95% CI 0.84, 1.91，Wald 卡方 p = 0.263）与生父与其同住的 AGYW 相比。对于父亲已故的 AGYW 来说，有其他成年男性作为家庭成员似乎可以降低发病率（怀孕：aIRR = 0.92，Wald 95% CI 0.74, 1.15，Wald 卡方 p = 0.462；HIV：aIRR = 0.90，Wald 95% CI 0.58, 1.39，Wald 卡方 p = 0.623），因此与父亲在家中的 AGYW 相似，因此在统计上没有显着差异。