High HIV seroconversion rates in adolescent girls and young women in KwaZulu-Natal South Africa

3 February 2023

Understanding HIV risk in young women in Africa is essential. In “HIV incidence and associated risk factors in adolescent girls and young women in South Africa: A population-based cohort study”, HIV seroconversion was measured in a cohort of adolescent girls and young women (AGYW) aged 15-24 years in peri-urban KwaZulu-Natal, South Africa.

CAPRISA statistician, Lara Lewis, applied Cox regression analysis and a proximate determinants framework, the study measured the associations between socio-demographic and behavioural variables and HIV seroconversion. The study highlighted the endemic high levels of HIV seroconversion among AGYW living in this region with an HIV incidence of 3.92 per 100 person-years (py). Among 15-19-year-olds, absence of family support (adjusted hazards ratio (aHR): 3.82 (95% CI: 1.89-7.72)), having a medically circumcised partner (aHR: 0.5 (CI 0.27-0.94)) or an HIV-positive partner not on antiretroviral therapy (ART) (aHR: 6.21 (CI 2.56-15.06)) were associated with HIV seroconversion. Among 20-24-year-olds, failure to complete secondary school (aHR: 1.89 (CI: 1.11-3.21)), inconsistent condom use (aHR: 3.01 (CI:1.14-7.96)) and reporting having partner(s) who were HIV-positive and not on ART (aHR: 7.75 (CI:3.06-19.66)) were associated with HIV seroconversion.  

In conclusion, HIV seroconversion was significantly associated with the absence of family support and incomplete schooling, while partner-level prevention interventions such as condom use, medical male circumcision, and ART associated HIV viral suppression played an important role in reducing HIV risk, justifying the need to intensify the use of combination HIV prevention programs.  

For more reading  see here: Lewis L, et al. PLoS One 2022 December; 17(12): e0279289. doi: 10.1371/journal.pone.0279289  


Figure: HIV incidence (per 100 person-years) by socio-demographic and behavioural risk factors among adolescent girls and young women enrolled in the HIPSS cohort