Household and Community-Level Determinants of HIV and Sexual Behavior Risk in Rural South Africa: Findings From the Agincourt Health and Sociodemographic Surveillance System and the Ha Nakekela Population-Based Study

Brian Houle , Australian National University
Shao-Tzu Yu, Australian National University
Chodziwadziwa Kabudula, University of the Witwatersrand
Nicole Angotti, American University
Enid Schatz, University of Missouri, Columbia
Sanyu Mojola, Princeton University

Variability in HIV prevalence in Sub-Saharan Africa across and within countries, even in small local areas, highlights the need to examine how community-level factors are associated with differential HIV risk. We aim to understand how individual and contextual-level factors impact on HIV and sexual risk behaviors. We use data from a 2010-2011 population-based study of men and women ages 15+ in rural South Africa. We use multi-level logistic regressions of HIV status and having multiple sexual partners in the past 2 years. We find that the poorest female-head households are more likely to have multiple sexual partners. For HIV status, being in a community with a higher than average proportion of employed adults is associated with lower odds of being HIV positive. The low level of within village correlation and high HIV prevalence across most villages suggests that it may be useful to target interventions to more proximal risk environments.

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 Presented in Session 10. Fertility, Family Planning, Sexual Behavior & Reproductive Health 2