Sexual Risk Factors for HIV Infection in Early and Advanced HIV Epidemics in Sub-Saharan Africa: Systematic Overview of 68 Epidemiological Studies
2007

Sexual Risk Factors for HIV Infection in Sub-Saharan Africa

Sample size: 90000 publication Evidence: high

Author Information

Author(s): Chen Li, Jha Prabhat, Stirling Bridget, Sgaier Sema K., Daid Tina, Kaul Rupert, Nagelkerke Nico

Primary Institution: Centre for Global Health Research, St. Michael's Hospital, University of Toronto

Hypothesis

Do sexual risk factors for HIV transmission change as HIV epidemics mature?

Conclusion

Sexual risk factors such as multi-partner sex, paid sex, and STIs remain significant for HIV transmission even in advanced epidemics.

Supporting Evidence

  • Women with 3+ sex partners had an odds ratio of 3.64 for HIV infection.
  • 9% of infected women reported ever having been paid for sex, compared to 4% of controls.
  • HIV infection risk was significantly associated with HSV-2 infection, with an odds ratio of 4.62 in women.

Takeaway

Having many sexual partners or paying for sex can increase the chances of getting HIV, even if the disease is common in the area.

Methodology

Systematic review of 68 studies involving HIV positive adults and controls, analyzing sexual risk factors and their associations with HIV infection.

Potential Biases

Possible underreporting of sexual behaviors due to social stigma.

Limitations

Most studies were cross-sectional, which may limit causal inferences; potential misclassification of self-reported risk factors.

Participant Demographics

Included 17,000 HIV positive adults and 73,000 controls from various African countries.

Statistical Information

Confidence Interval

95%CI [2.87–4.62]

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pone.0001001

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