ArticleAIDS (London, England)2017
Age-disparate relationships and HIV incidence in adolescent girls and young women: evidence from Zimbabwe.
Article in AIDS (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 92 papers, 2 of them syntheses that pooled it.
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Who cites it
92 citing papers in PubMed, 2 syntheses or guidelines pooled it, 151 citations in OpenAlex.
- A Systematic Review of Randomized Controlled Trials of School Based Interventions on Sexual Risk Behaviors and Sexually Transmitted Infections Among Young Adolescents in Sub-Saharan Africa.AIDS and behavior · 2021Pooled it
- Recent levels and trends in HIV incidence rates among adolescent girls and young women in ten high-prevalence African countries: a systematic review and meta-analysis.The Lancet. Global health · 2019Pooled it
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- Impact of Partner-Related Social Harms on Women's Adherence to the Dapivirine Vaginal Ring During a Phase III Trial.Journal of acquired immune deficiency syndromes (1999) · 2018Trial
- Young widowhood as a predictor of HIV risk behaviors in a high HIV prevalence setting in Siaya County, Kenya.Global health action · 2026Article
- Development of a Self-administered Sexual Behavior Assessment Tool to Facilitate Self-reflection by Young Women in South Africa About HIV/STI Risk.AIDS and behavior · 2026Article
- The Prevalence and Factors Associated With HIV Testing among Adolescent Girls and Young Women in the Gambia-Evidence From the 2019/2020 Demographic and Health Survey.Health science reports · 2026Article
- Sexual Relationship Typologies, Multilevel Determinants, and HIV Among Adolescent Mothers in Eastern and Southern Africa: A Multilevel Latent Class Analysis.AIDS and behavior · 2026Article
- Geospatial mobility, non-local partners, concurrent sexual partnerships, and gender influence longitudinal STI prevalence in rural eastern Africa.International journal of STD & AIDS · 2026Article
- Prevalence and determinants of being out-of-care among HIV-positive young people aged 15-24 years in Mozambique: findings from the 2021 population-based HIV impact assessment survey.BMC infectious diseases · 2026Article
- Barriers to and Facilitators of Heterosexual Men's Engagement with the PrEP Care Continuum in Sub-Saharan Africa: A Scoping Review.AIDS and behavior · 2026Article
- "Something Like That": Awareness and Acceptability of HIV PrEP and PEP Among Kenyan Adolescents.International journal of behavioral medicine · 2025Article
- Factors associated with HIV infection among adolescents and young people in Mozambique: sub-analysis of immunization, malaria and HIV/AIDS indicator survey in Mozambique-IMASIDA 2015.BMC public health · 2025Article
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- Article
- Dynamic HIV risk differentiation among youth: Validation of a tool for prioritization of prevention in East Zimbabwe.medRxiv : the preprint server for health sciences · 2024Article
- Adolescents' risky sexual behaviours and practices: Implications for sexuality education implementation in Zambia.African journal of primary health care & family medicine · 2024Article
- Investigating the Associations between Drought, Poverty, High-Risk Sexual Behaviours, and HIV Incidence in Sub-Saharan Africa: A Cross-Sectional Study.AIDS and behavior · 2024Article
32 more citing papers are in PubMed but not listed here.
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
Abstract
objectiveAge-disparate sexual relationships with older men may drive high rates of HIV acquisition in young women in sub-Saharan Africa, but evidence is limited. We investigate the association between age-disparate relationships and HIV incidence in Manicaland, Zimbabwe.
designA general-population open-cohort study (six surveys) (1998-2013).
methodsA total of 3746 young women aged 15-24 years participated in consecutive surveys and were HIV-negative at the beginning of intersurvey periods. Last sexual partner age difference and age-disparate relationships [intergenerational (≥10 years age difference) and intragenerational (5-9 years) versus age-homogeneous (0-4 years)] were tested for associations with HIV incidence in Cox regressions. A proximate determinants framework was used to explore factors possibly explaining variations in the contribution of age-disparate relationships to HIV incidence between populations and over time.
resultsAbout 126 HIV infections occurred over 8777 person-years (1.43 per 100 person-years; 95% confidence interval = 1.17-1.68). Sixty-five percent of women reported partner age differences of at least 5 years. Increasing partner age differences were associated with higher HIV incidence [adjusted hazard ratio (aHR) = 1.05 (1.01-1.09)]. Intergenerational relationships tended to increase HIV incidence [aHR = 1.78 (0.96-3.29)] but not intragenerational relationships [aHR = 0.91 (0.47-1.76)]. Secondary education was associated with reductions in intergenerational relationships [adjusted odds ratio (aOR) = 0.49 (0.36-0.68)]. Intergenerational relationships were associated with partners having concurrent relationships [aOR = 2.59 (1.81-3.70)], which tended to increase HIV incidence [aHR = 1.74 (0.96-3.17)]. Associations between age disparity and HIV incidence did not change over time.
conclusionSexual relationships with older men expose young women to increased risk of HIV acquisition in Manicaland, which did not change over time, even with introduction of antiretroviral therapy.
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