ArticlePloS one2018
High HIV incidence and low uptake of HIV prevention services: The context of risk for young male adults prior to DREAMS in rural KwaZulu-Natal, South Africa.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled it.
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Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Estimates of the prevalence of male circumcision in sub-Saharan Africa from 2010-2023-A systematic review and meta-analysis.PloS one · 2024Pooled 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
- Alcohol Use and the Pre-exposure Prophylaxis Continuum of Care Among Men in Rural South Africa: Results from a Longitudinal Study.AIDS and behavior · 2025Trial
- Trial
- Impact of family networks on uptake of health interventions: evidence from a community-randomized control trial aimed at increasing HIV testing in South Africa.Journal of the International AIDS Society · 2023Trial
- Trial
- Thetha Nami: participatory development of a peer-navigator intervention to deliver biosocial HIV prevention for adolescents and youth in rural South Africa.BMC public health · 2021Trial
- Effect of peer-distributed HIV self-test kits on demand for biomedical HIV prevention in rural KwaZulu-Natal, South Africa: a three-armed cluster-randomised trial comparing social networks versus direct delivery.BMJ global health · 2021Trial
- The impact of the DREAMS partnership on HIV incidence among young women who sell sex in two Zimbabwean cities: results of a non-randomised study.BMJ global health · 2021Trial
- Adaptation and Evaluation of a Multi-Component School-Based Sexual Reproductive Health Intervention Safer Choices Programme in Rural KwaZulu-Natal, South Africa - A Process Evaluation.Journal of the International AIDS Society · 2026Article
- Sexual and reproductive health interventions for mobile adolescents and young people in sub-Saharan Africa: a scoping review.BMC public health · 2025Article
- Programme Science: a route to transformative change to improve population-level impact for global HIV and sexually transmitted infections.Journal of the International AIDS Society · 2024Article
- HIV transmission dynamics and population-wide drug resistance in rural South Africa.Nature communications · 2024Article
- Article
- Uptake of multi-level HIV interventions and HIV-related behaviours among young people in rural South Africa.PLOS global public health · 2024Article
- HIV transmission dynamics and population-wide drug resistance in rural South Africa.Research square · 2023Article
- Knowledge of HIV and/or AIDS and HIV testing services among young men in South Africa.African journal of primary health care & family medicine · 2023Article
- Adaptation and pre-test of a shortened Stepping Stones and Creating Futures intervention focused on HIV for young men in rural South Africa.PLOS global public health · 2023Article
- Article
- Defining the Global Research and Programmatic Agenda and Priority Actions for Voluntary Medical Male Circumcision for HIV Prevention.Current HIV/AIDS reports · 2022Review
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16 authors.
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Abstract
backgroundYoung men are less likely than young women to engage with HIV prevention and care, and their HIV-related mortality is higher. We describe HIV incidence and uptake of HIV services in men 20-29 years(y) in rural KwaZulu-Natal, South Africa, before the roll-out of DREAMS.
methodsWe used data from a population-based demographic and HIV surveillance cohort. HIV incidence was estimated from anonymised testing in an annual serosurvey. Service uptake was assessed in 2011 and 2015, through two self-reported outcomes: 1) HIV testing in the past 12 months(m); 2) voluntary medical male circumcision(VMMC). Logistic regression was used to estimate odds ratios(OR) and 95% confidence intervals(CI) for factors associated with each outcome.
resultsHIV incidence in 2011-2015 was 2.6/100 person-years (95%CI = 2.0-3.4) and 4.2 (95%CI = 3.1-5.6) among men 20-24y and 25-29y, respectively, with no significant change from 2006-2010. N = 1311 and N = 1221 young men participated in the 2011 and 2015 surveys, respectively. In both years, <50% reported testing for HIV in the past 12m. In 2011, only 5% reported VMMC, but coverage in 2015 increased to 40% and 20% in men 20-24y and 25-29y, respectively. HIV testing was positively associated with higher education and mobility. Testing uptake was higher in men reporting >1 partner in the past 12m, or condom use at last sex, but lower in those reporting a casual partner (adjusted (a)OR = 0.53, 95%CI = 0.37-0.75). VMMC uptake was associated with survey year and higher education. Men aged 25-29y and those who were employed (aOR = 0.66; 95%CI = 0.49-0.89) were less likely to report VMMC.
conclusionsHIV incidence in men 20-29y was very high, and pre-exposure prophylaxis (PrEP) should be considered in this population. Uptake of services was low. VMMC coverage increased dramatically from 2011 to 2015, especially among younger men, suggesting a demand for this service. Interventions designed with and for young men are urgently needed.
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