Determinants of Self-Perceived HIV Risk in Young South Africans Engaged in Concurrent Sexual Relationships

This 12-page research article, published in the African Journal of Reproductive Health, examines factors that determine whether people in multiple concurrent relationships develop a perception of being at risk for HIV infection. Data was analysed from a sample of 2245 young sexually active men and women in Cape Town, South Africa. Researchers found that only 19% of youth in Cape Town regard themselves as being at some or great risk of HIV. Only 24% of those in the group involved in concurrent sexual relationships consider themselves to be at risk of HIV.

According to the article, the research used data from the Cape Area Panel Survey (CAPS), which is a representative longitudinal study of adolescents aged 14-25 living in Cape Town. Participants were interviewed about demographic information, education, employment, health ailments, and sexual behaviour histories. They were asked to assess their own risk of being infected with HIV. Based on their responses, participants were classified into two groups - high risk and low risk.

The research found that concurrency was correlated with higher risk perceptions among coloured and white respondents, but not Africans, who had the highest concurrency rates. The authors state that this identifies an area of HIV prevention requiring urgent attention. The report also found that among black males, people with intermediate levels of education (secondary level up to grade 12) were less likely to perceive their HIV risk than those with only primary or with post-secondary education. This suggests that the life skills based education in secondary schools and various national communication strategies are failing to adequately convey the dangers of concurrency to pupils.

The research found that using drugs such as marijuana is associated with an increased risk perception. In addition, among the low risk group, parents discussing HIV had an effect on HIV risk perception in males. Amongst females, the report states that a longer time since sexual debut, having experienced sexual coercion, a greater number of sex partners in the past year, and knowing someone who died of AIDS were correlated with an increased HIV risk perception.

According to the authors, there is a need to devise culturally appropriate ways to better communicate the risk of concurrency, as well as deal with the myriad of structural and other factors in order to allow young people to develop the autonomy and capacity for critical thinking that is necessary for behaviour change.

The authors suggest that a key audience for new campaigns would need to be young African males as they have both the highest concurrency rates and a lower perception of HIV risk than other males. The article concludes that social identity literature is useful in this regard as it illustrates both how group norms are shaped and constrained, but also how they can be renegotiated.