The Roles of Youth in Intimate Partner Relationships and the Perceived Risk of HIV Infection in South Africa

Abstract

Background: Young people in South Africa face multiple developmental challenges, including violence and HIV infection. Objective: This study examines the various roles of youth in violent intimate relationships (IPV) and its association with the perceived risk of HIV infection. Results from this study could assist in youth development programmes to increase HIV testing, as well as inform modifications to the South African Domestic Violence Act (No. 116 of 1998), which addresses all forms of intimate partner violence in the country. Methods: The study uses data from the South African National HIV Prevalence, HIV Incidence, Behaviour and Communication Survey (SABSSM) 2017. The study population is youth (15-24 years old) who responded to a question on their perceived risk of being infected with HIV. A weighted sample (N) of 1,301,550 youth is included. The main independent variable is the 'role in IPV', and the study controls for the demographic, socioeconomic, and HIV knowledge and sexual behaviours of youth. Cross-tabulations and a multivariate binary logistic regression model are used to determine the relationship between controls and the outcome. Results: About 20% of youth perceive themselves at risk of being with HIV. Their reasons for believing this are because they are sexually active, do not use condoms consistently, and do not trust their partners. Only about 4% of IPV perpetrators, compared to 23.71% of victims and 23.16% of bidirectional youth, think it is likely they will get infected with HIV. The odds of perceiving themselves at risk are higher (with p-values<0.05) for victims (OR=1.21), 20-24 years old (OR=1.35), female (OR=1.25), those who responded do not think condoms reduce the risk of HIV (OR=1.49) and those who do not use condoms (OR=1.44) among others. Conclusion: IPV behaviours are associated with perceived HIV risk among young people in South Africa. For perception to change and allow youth to adopt protective behaviours against HIV, there is a need for policy to target the different roles of youth.