Influence of Partner Characteristics on HIV Acquisition among Youth in Rakai, Uganda

Background: HIV risk is influenced by individual-level factors and by the behaviors and characteristics of sexual partners. We examined the contribution of partner characteristics on HIV acquisition among young people in rural Uganda, controlling for individual-level risk factors.

Methods: We used self-reported data from 15-24 years-olds from a population-based cohort (2005-2011) on up to four most recent sexual partners in the last year (n=9,062 partners across 7,080 participants). Poisson regression was used to calculate incident rate ratios (IRR). 

Results: In bivariate analyses, young women’s risk of HIV acquisition increased if they had non-marital partners, if their partners were older, lived outside her home or community, drove a truck, were not in school, had other partners, drank alcohol before sex, used condom inconsistently, and were described as being at risk of HIV. Young men’s risk of HIV acquisition increased with similar partner characteristics, but also if they had partnerships of shorter duration and with higher coital frequency. Multivariate analyses adjusting for individual-level risk factors, showed that young women’s likelihood of HIV acquisition increased with each non-marital sexual partner (IRR: 1.54 [1.20-1.98]), each partner who drank alcohol before sex (IRR: 1.57 [1.11-2.21]), and each partner who used condoms inconsistently (IRR: 1.99 [1.33-2.04]). Among young men, only having non-marital partnerships increased HIV acquisition (IRR for each partner: 1.54[1.20, 1.98]).

Conclusions: Partner characteristics predicted HIV acquisition among youth. HIV prevention programs should emphasize knowledge of partners and characteristics of partners that increase HIV risk, in addition to current HIV prevention strategies.