Factors associated with HIV sero-positivity in young, rural South African men

R. Jewkes, K. Dunkle, M. Nduna, J. Levin, N. Jama, N. Khuzwayo, M. Koss, A. Puren, N. Duvvury

Research output: Contribution to journalArticlepeer-review

56 Scopus citations


Objective: To describe factors associated with HIV infection in men aged 15-26 years. Setting: Rural Eastern Cape Province, South Africa. Sample: A total of 1277 sexually experienced Xhosa male volunteers from 70 villages participating in a cluster randomized controlled trial of an HIV behavioural intervention. Xhosas circumcise during manhood initiation rituals. Design: Cross-sectional, analysis of the study's baseline interviews. Main measure HIV sero-status, sexual practices measured with an interviewer-administered questionnaire. Results: About 2% of the men were HIV positive. A logistic regression model showed HIV positivity to be associated with age (OR 1.55; 95%CI 1.22-1.95), having made a woman pregnant (OR 2.93; 95% CI 1.28-6.68), having been circumcised (OR 0.40; 95% CI 0.16-0.98), and having had sex with a man (OR 3.61; 95% CI 1.0-13.0). Conclusions: Our findings provide further evidence to suggest that circumcision is protective. There was much heterosexual risk taking among men but only pregnancy (with its association with sexual frequency) predicted HIV sero-positivity. Although relatively rare, same-sex sexual experiences were a risk factor. Male-male sexual contact is rarely assessed in HIV research in Africa and almost never addressed in general HIV prevention programming. Our findings suggest that it should be given more attention.

Original languageEnglish (US)
Pages (from-to)1455-1460
Number of pages6
JournalInternational Journal of Epidemiology
Issue number6
StatePublished - Dec 2006


  • Circumcision
  • HIV
  • Heterosexual men
  • MSM
  • Rural
  • South Africa

ASJC Scopus subject areas

  • Epidemiology


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