HIV vulnerability among adolescent girls and young women: a multi-country latent class analysis approach

• DOI: 10.1007/s00038-020-01350-1
• Publication Date: 2020-04-09T02:02:33Z
• Authors: Sanyukta Mathur; Nanlesta Pilgrim; Sangram Kishor Patel; Jerry Okal; Victor Mwapasa; Effie Chipeta; Maurice Musheke; Bidhubhusan Mahap...; Julie Pulerwitz
• Keywords: Health Knowledge, Attitudes, Practice; Adolescent; Sexual Behavior; Sex Offenses; 1. No poverty; HIV Infections; 3. Good health; Young Adult; 03 medical and health sciences; Socioeconomic Factors; 5. Gender equality; Latent Class Analysis; 11. Sustainability; Humans; Women's Health; Original Article; Female; 10. No inequality; 0305 other medical science; Africa South of the Sahara

To stem the HIV epidemic among adolescent girls and young women (AGYW, 15-24 years), prevention programs need to reach AGYW who are most at risk. We examine whether individual- and household-level factors could be used to define HIV vulnerability for AGYW.We surveyed out-of-school AGYW in urban and peri-urban Kenya (N = 1014), in urban Zambia (N = 846), and in rural Malawi (N = 1654) from October 2016 to 2017. LCA identified classes based on respondent characteristics, attitudes and knowledge, and household characteristics. Multilevel regressions examined associations between class membership and HIV-related health outcomes.We identified two latent classes-high and low HIV vulnerability profiles-among AGYW in each country; 32% of the sample in Kenya, 53% in Malawi, and 51% in Zambia belonged to the high vulnerability group. As compared to AGYW with a low-vulnerability profile, AGYW with a high-vulnerability profile had significantly higher odds of HIV-related outcomes (e.g., very early sexual debut, transactional sex, sexual violence from partners).Out-of-school AGYW had differential vulnerability to HIV. Interventions should focus on reaching AGYW in the high HIV vulnerability profiles.