Neighborhood, poverty, and adolescent sexual risk-taking behaviors in Kwazulu-Natal, South Africa
Description
Background. Although monetary poverty is undoubtedly a primary cause of increased vulnerability to HIV/AIDS, there is a growing body of literature that stresses the need to explore and document other, largely invisible, assets at the community-level that may be used to mitigate the negative association between 'poverty' and increased HIV/AIDS risk for adolescents. Objective. Determine if the significant association between household poverty and increased participation in HIV sexual risk-taking behaviors is attenuated by neighborhood characteristics of social organization (human capital, social capital, neighborhood physical conditions and safety). Methods. 3,052 South African youth between the ages of 15--22 were interviewed and included in the study. In addition, information was collected from 2,007 households, as well as information regarding 113 of the surrounding enumeration areas (EAs) through direct community observation. Contextual models were run for three sexual risk-taking behaviors of interest: Timing of sexual initiation, condom use at sexual initiation, and the consistent use of condoms with up to three partners. Results . Overall, human capital appeared to have the strongest mitigating effect on the poverty-sexual risk-taking behavior relationship for boys. Community-level social organization, however, did not attenuate girls' risk of increased sexual risk-taking behaviors. In fact, the negative effect of poverty on girls' increased risk for HIV/AIDS was often exacerbated when factors at the structural level were taken into account. Conclusions. The results of this study indicate that while HIV/AIDS risk may decrease for disadvantaged boys living in more socially organized neighborhoods, poverty remains a primary HIV/AIDS risk factor for girls, regardless of the available assets at the community level