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HIV Prevalence and Associated Factors Among Men in South Africa 30 Years into the Epidemic: The Fifth Nationwide Cross-Sectional Survey

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Abstract

We investigated HIV prevalence and associated factors among men ≥ 15 years in South Africa using data from a 2017 nationwide cross-sectional survey. HIV prevalence was 10.5% among 6 646 participants. Prevalence increased from 4.1% in the younger men (15–24 years), 12.5% in young men (25–34 years) to 12.7% in older men (≥ 35 years). Odds of being infected with HIV were lower among younger men who had secondary level education and those who reported poor/fair self-rated health. Young and older men of other race groups had lower odds of HIV infection. Odds of infection were lower among young men who had moderate/high exposure to HIV communication programmes. Men not aware of their HIV status had higher odds of HIV infection, including older men who never married. Improved access to education, behavioral change programmes, and awareness of HIV status are necessary to reduce the risk of HIV infection among Black African men.

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References

  1. Simbayi L, Zuma K, Zungu N, Moyo S, Marinda E, Jooste S, et al. South African National HIV prevalence, incidence, behaviour and communication survey, 2017. Cape Town: HSRC Press; 2019.

    Google Scholar 

  2. UNAIDS. Global AIDS update. Geneva: UNAIDS; 2019.

    Google Scholar 

  3. Tshabalala J, Visser M. Developing a cognitive behavioural therapy model to assist women to deal with HIV and stigma. South Afr J Psychol. 2011;41(1):17–28.

    Article  Google Scholar 

  4. Birdthistle I, Tanton C, Tomita A, de Graaf K, Schaffnit SB, Tanser F, et al. Recent levels and trends in HIV incidence rates among adolescent girls and young women in ten high-prevalence African countries: a systematic review and meta-analysis. Lancet Glob Health. 2019;7(11):e1521–40.

    Article  Google Scholar 

  5. Mabaso M, Sokhela Z, Mohlabane N, Chibi B, Zuma K, Simbayi L. Determinants of HIV infection among adolescent girls and young women aged 15–24 years in South Africa: a 2012 population-based national household survey. BMC Public Health. 2018;18(1):183.

    Article  Google Scholar 

  6. Kimanga DO, Ogola S, Umuro M, Ng’ang’a A, Kimondo L, Murithi P, et al. Prevalence and incidence of HIV infection, trends, and risk factors among persons aged 15–64 years in Kenya: results from a nationally representative study. J Acquir Immune Defic Syndr. 2014;66(Suppl 1):S13–26.

    Article  Google Scholar 

  7. Pascoe L, Peacock D, Stemple L. Reaching men: addressing the blind spot in the HIV response. Int J Mens Social Commun Health. 2018;1(SP1):e57–70.

    Article  Google Scholar 

  8. Shand T, Thomson-de Boor H, van den Berg W, Peacock D, Pascoe L. The HIV blind spot: men and HIV testing, treatment and care in sub-Saharan Africa. IDS Bull. 2014;45(1):53–60.

    Article  Google Scholar 

  9. UNAIDS. Reaching out to men and boys: addressing a blind spot in the response to HIV. Geneva: UNAIDS; 2017.

    Google Scholar 

  10. Macdonald JA, Graeme LG, Wynter K, Cooke D, Hutchinson D, Kendall G, et al. How are you sleeping? Starting the conversation with fathers about their mental health in the early parenting years. J Affect Disord. 2021;281:727–37.

    Article  Google Scholar 

  11. Muula AS, Ngulube TJ, Siziya S, Makupe CM, Umar E, Prozesky HW, et al. Gender distribution of adult patients on highly active antiretroviral therapy (HAART) in Southern Africa: a systematic review. BMC Public Health. 2007;7(1):63.

    Article  Google Scholar 

  12. Ferradini L, Jeannin A, Pinoges L, Izopet J, Odhiambo D, Mankhambo L, et al. Scaling up of highly active antiretroviral therapy in a rural district of Malawi: an effectiveness assessment. The Lancet. 2006;367(9519):1335–42.

    Article  Google Scholar 

  13. Ochieng-Ooko V, Ochieng D, Sidle JE, Holdsworth M, Wools-Kaloustian K, Siika AM, et al. Influence of gender on loss to follow-up in a large HIV treatment programme in western Kenya. Bull World Health Organ. 2010;88:681–8.

    Article  Google Scholar 

  14. Hawkins C, Chalamilla G, Okuma J, Spiegelman D, Hertzmark E, Aris E, et al. Sex differences in antiretroviral treatment outcomes among HIV-infected adults in an urban Tanzanian setting. AIDS. 2011;25(9):1189–97.

    Article  CAS  Google Scholar 

  15. Druyts E, Dybul M, Kanters S, Nachega J, Birungi J, Ford N, et al. Male sex and the risk of mortality among individuals enrolled in antiretroviral therapy programs in Africa: a systematic review and meta-analysis. AIDS. 2013;27(3):417–25.

    Article  Google Scholar 

  16. Dovel K, Yeatman S, Watkins S, Poulin M. Men’s heightened risk of AIDS-related death: the legacy of gendered HIV testing and treatment strategies. AIDS. 2015;29(10):1123.

    Article  Google Scholar 

  17. Cornell M, Myer L. Moving beyond gender stereotypes. The Lancet. 2013;382(9891):506.

    Article  Google Scholar 

  18. Buvé A, Bishikwabo-Nsarhaza K, Mutangadura G. The spread and effect of HIV-1 infection in sub-Saharan Africa. The Lancet. 2002;359(9322):2011–7.

    Article  Google Scholar 

  19. Buvé A, Caraël M, Hayes RJ, Auvert B, Ferry B, Robinson NJ, et al. Multicentre study on factors determining differences in rate of spread of HIV in sub-Saharan Africa: methods and prevalence of HIV infection. AIDS. 2001;15:S5–14.

    Article  Google Scholar 

  20. Dyson T. HIV/AIDS and urbanization. Popul Dev Rev. 2003;29(3):427–42.

    Article  Google Scholar 

  21. Bärnighausen T, Hosegood V, Timaeus IM, Newell M-L. The socioeconomic determinants of HIV incidence: evidence from a longitudinal, population-based study in rural South Africa. AIDS. 2007;21(Suppl 7):S29.

    Article  Google Scholar 

  22. Shisana O, Rehle T, Simbayi L, Zuma K, Jooste S, Pillay-van-Wyk V, et al. South African National HIV prevalence, incidence, behaviour and communication survey, 2008: a turning tide among teenagers? Cape Town: HSRC Press; 2009.

    Google Scholar 

  23. Shisana O, Rehle T, Simbayi LC, Zuma K, Jooste S, Zungu N, et al. South African national HIV prevalence, incidence and behaviour survey, 2012. Cape Town: HSRC Press; 2014.

    Google Scholar 

  24. Statistics South Africa. Mid-year population estimates 2017. Pretoria: Statistics South Africa; 2017.

    Google Scholar 

  25. Saunders JB, Aasland OG, Babor TF, De la Fuente JR, Grant M. Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction. 1993;88(6):791–804.

    Article  CAS  Google Scholar 

  26. Zuma K, Simbayi L, Rehle T, Mbelle N, Zungu N, North A, et al. Health and wellbeing of our educators and school-based officials in public schools in South Africa, 2015–2016. Cape Town: HSRC Press; 2016.

    Google Scholar 

  27. Kayeyi N, Sandøy IF, Fylkesnes K. Effects of neighbourhood-level educational attainment on HIV prevalence among young women in Zambia. BMC Public Health. 2009;9(1):310.

    Article  Google Scholar 

  28. Hargreaves JR, Glynn JR. Educational attainment and HIV-1 infection in developing countries: a systematic review. Trop Med Int Health. 2002;7(6):489–98.

    Article  Google Scholar 

  29. Siziya S, Fylkesnes K. Impact of HIV infection on self-rated health in a high-prevalence popolation with low awareness of own HIV status. Norsk J Epidemiol. 2005. https://doi.org/10.5324/nje.v15i2.215.

    Article  Google Scholar 

  30. Kenyon C, Dlamini S, Boulle A, White RG, Badri M. A network-level explanation for the differences in HIV prevalence in South Africa’s racial groups. Afr J AIDS Res. 2009;8(3):243–54.

    Article  Google Scholar 

  31. Reniers G. Marital strategies for regulating exposure to HIV. Demography. 2008;45(2):417–38.

    Article  Google Scholar 

  32. Shisana O, Risher K, Celentano DD, Zungu N, Rehle T, Ngcaweni B, et al. Does marital status matter in an HIV hyperendemic country? Findings from the 2012 South African National HIV prevalence. Incid Behav Surv AIDS Care. 2016;28(2):234–41.

    Google Scholar 

  33. Shisana O, Zungu-Dirwayi N, Toefy Y, Simbayi L, Malik S, Zuma K. Marital status and risk of HIV infection in South Africa. South Afr Med J. 2004;94(7):537–43.

    CAS  Google Scholar 

  34. Nabukenya AM, Nambuusi A, Matovu JK. Risk factors for HIV infection among married couples in Rakai, Uganda: a cross-sectional study. BMC Infect Dis. 2020;20(1):1–8.

    Article  Google Scholar 

  35. Mazhnaya A, Andreeva TI, Samuels S, DeHovitz J, Salyuk T, McNutt LA. The potential for bridging: HIV status awareness and risky sexual behaviour of injection drug users who have non-injecting permanent partners in Ukraine. J Int AIDS Soc. 2014;17(1):18825.

    Article  Google Scholar 

  36. Rosenberg NE, Pettifor AE, Bruyn GD, Westreich D, Delany-Moretlwe S, Behets F, et al. HIV testing and counseling leads to immediate consistent condom use among South African stable HIV-discordant couples. J Acquir Immune Defic Syndr. 2013;62(2):226.

    Article  Google Scholar 

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Funding

This paper was supported by the President’s Emergency Plan for AIDS Relief through the Centers for Disease Control and Prevention under the terms of Cooperative Agreement Number NU2GGH001629. Additional funding was also received from the South African Department of Science and Technology (now known as the Department of Science and Innovation), South African National AIDS Council, The Global Fund to Fight AIDS, Tuberculosis and Malaria, Right to Care, United Nations Children’s Fund (UNICEF), The Centre for Communication Impact, Soul City, and LoveLife. The findings and conclusions of this paper are those of the authors, and do not necessarily represent the official position of the funding agencies.

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Authors and Affiliations

  1. Human Sciences Research Council, 5th Floor, The Atrium, 430 Peter Mokaba Ridge, Berea, Durban, 4001, South Africa

    Tawanda Makusha, Musawenkosi Mabaso, Sizulu Moyo, Nompumelelo Zungu, Khangelani Zuma & Leickness Simbayi

  2. MRC/Wits Developmental Pathways for Health Research Unit (DPHRU), School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa

    Tawanda Makusha

  3. DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa

    Tawanda Makusha

  4. School of Public Health, University of Cape Town, Cape Town, South Africa

    Sizulu Moyo

  5. Department of Psychology, University of Pretoria, Pretoria, South Africa

    Nompumelelo Zungu

  6. School of Public Health, University of the Witwatersrand, Johannesburg, South Africa

    Khangelani Zuma

  7. Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa

    Leickness Simbayi

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  1. Tawanda Makusha
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  2. Musawenkosi Mabaso
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  3. Sizulu Moyo
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  4. Nompumelelo Zungu
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  5. Khangelani Zuma
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  6. Leickness Simbayi
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Correspondence to Tawanda Makusha.

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Makusha, T., Mabaso, M., Moyo, S. et al. HIV Prevalence and Associated Factors Among Men in South Africa 30 Years into the Epidemic: The Fifth Nationwide Cross-Sectional Survey. AIDS Behav 26, 986–995 (2022). https://doi.org/10.1007/s10461-021-03453-z

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  • DOI: https://doi.org/10.1007/s10461-021-03453-z

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