Are Adolescent Orphans More Likely to be HIV-Positive? A Pooled Data Analyses Across 19 Countries in Sub-Saharan Africa
BACKGROUND:
Despite
extensive resources and numerous programmes directed towards orphans in sub-Saharan
Africa, evidence of
their disadvantage is surprisingly limited. While initial research suggests that
orphans are at greater risk of
being HIV-positive, the evidence is
limited in geographic scope.
METHODS:
To rigorously
test disparities in HIV prevalence
related to orphanhood and parental HIV status
in sub-Saharan Africa, we used Demographic and Health Survey data from 19 countries
in sub-Saharan Africa. We conducted pooled multilevel logistic regression on adolescents
aged 15-17 years with HIV test
results (N=22 837 girls and 20 452 boys).
RESULTS:
Regardless
of their gender, orphans who lost their mother, lost both parents or had an HIV-infected mother were
two to three times more likely to test positive for HIV infection (ORs 1.87-3.17). The loss of a father was
also associated with HIV infection risk for females, but of slightly lower magnitude (OR 1.63).
CONCLUSIONS:
To
better inform interventions, future research is needed to quantify the relative
contribution of perinatally-acquired and sexually-acquired infections, and to investigate
the specific mechanisms that may account for disparities in the latter. In the meantime,
programmes servingHIV-infect adults as well
as those serving orphaned and vulnerable children should invest in family-based HIV testing in order to identify adolescents in need of
treatment.
- 1Program in Public Health and Department of Family, Population & Preventative Medicine, Stony Brook University, Health Sciences Center, Stony Brook, New York, USA.
- 2Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA.
- J Epidemiol Community Health. 2016 Feb 10. pii: jech-2015-206744. doi: 10.1136/jech-2015-206744.
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