Sex and secrecy: knowledge of HIV status, disclosure and sexual practices among HIV-positive adolescents in South Africa

Event type: 
Seminar
Date and time: 
Tuesday, 24 March, 2015 - 12:45 to 14:00
Presenter(s): 
Rebecca Hodes (AIDS and Society Research Unit, Centre for Social Science Research, UCT) and Elona Toska (Social Policy and Intervention, Oxford University)
Venue: 
CSSR Seminar Room 4.29, Level 4 Leslie Social Science Building, Upper Campus
Abstract / Description: 

HIV-positive adolescents who engage in unsafe sex are at heightened risk for transmitting or re-acquiring HIV. Disclosure of HIV-status to sexual partners may impact on condom use, but no large-scale, mixed methods studies have explored the effects of adolescent knowledge of one’s HIV status, knowledge of partner status, and disclosure to partners on safer sex. This study aimed to identify whether knowledge of HIV-status by HIV-positive adolescents and partners was associated with safer sex. 684 HIV-positive adolescents who had ever initiated ART in 39 health facilities in the Eastern Cape, South Africa, were interviewed using standardised questionnaires. Quantitative analyses used multivariate logistic regressions, controlling for confounders. Qualitative research included interviews, focus group discussions and observations with 43 HIV-positive teenagers, and their caregivers and healthcare workers. Knowledge of HIV-status among HIV-positive adolescents was associated with safer sexual practices, but knowing partner’s status and disclosure of HIV-positive status to sexual partners were not. These findings challenge assumptions that disclosure is automatically protective in sexual and romantic relationships for HIV-positive adolescents.