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Young people who acquire HIV in Uganda report poor communication and mistrust in their relationships
Roger Pebody, 2014-02-20 08:10:00
Compared with young people who remain HIV negative, recent seroconverters in Rakai, Uganda describe sexual relationships marked by poorer communication, greater suspicion and mistrust, and larger and more transitory sexual networks.
The study highlights the importance of relational approaches to HIV prevention, the researchers comment in the American Journal of Public Health.
As in many other African settings, young women in this rural area of Uganda have a very high risk of acquiring HIV, particularly during their teenage years. Previous quantitative research in young people in Rakai has identified a number of risk factors that raise the risk of HIV infection – multiple partners, concurrent sexual relationships, drinking alcohol, and having sexually transmitted infections. The risk for new infections is strongly shaped by social transitions such as leaving school or a marriage.
For the current study, the researchers adopted an innovative methodology – a case-control study using qualitative life-history interviews. Thirty men and women aged 15 to 24 who had acquired HIV in the previous year were the cases, while thirty people who had remained HIV negative were the controls. Pairs of cases and controls were matched in terms of gender, marital status, age group, and place of residence.
The researchers collected and compared detailed accounts of the participants’ lives in order to explore the contextual factors that help explain why some young people acquired HIV while others had not.
Not all of those living with HIV were aware of their HIV status (some had chosen not to receive results). Moreover, the interviewers had not been informed of the HIV status of their interviewees, which should help reduce bias. In addition, because interviews took place within a year of HIV seroconversion, participants’ recall of recent events is likely to be relatively accurate.
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