December 1, 2011
Seeking to better understand the potential role of sexual behavior in HIV transmission in two countries with strikingly different HIV epidemics -- the United States and South Africa -- the study authors used nationally representative, population-based surveys of people ages 18-24 to compare sexual behaviors.
Data from 7,548 South African young people and 13,451 US youths showed HIV prevalence of 10.2 percent in South Africa and less than 1 percent in the United States. Young men and women in the United States reported an earlier age of first sex than their South African counterparts (mean age of coital debut for women: US [16.5], SA [17.4]; for men: US [16.4], SA [16.7]). US participants reported a higher median number of lifetime partners (women: US , SA ; men: US , SA ). Reported condom use at last sex was lower among US youths (women: US [36.1 percent], SA [45.4 percent]; men, US [48 percent], SA [58 percent]). On average, young South African women reported greater age differences with their sex partners than young US women.
"Young people in the US report riskier sexual behaviors than young people in SA, despite the much higher prevalence of HIV infection in SA. Factors above and beyond sexual behavior likely play a key role in the ongoing transmission of HIV in South African youth, and thus should be urgently uncovered to develop maximally effective prevention strategies," the authors concluded.
Journal of Adolescent Health
09.2011; Vol. 49; No. 3: P. 237-243.e; Audrey E. Petifor, Ph.D., M.P.H.; Brooke A. Levandowski, Ph.D.; Catherine Macphail, Ph.D.; William C. Miller, M.D., Ph.D.; Joyce Tabor, M.S.; Carol Ford, M.D.; Cheryl R. Stein, Ph.D.; Helen Rees, M.D.; Myron Cohen, M.D.
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