Brief Report: Sexual Partnership Heterogeneity and HIV Seropositivity Among Adolescent Girls and Young Women in Cameroon and Côte d'Ivoire: A Partner-Level Latent Class Analysis.

BACKGROUND

Adolescent girls' and young women's (AGYW) heightened HIV vulnerability has been understudied in West and Central Africa, where AGYW account for 1 in 5 new HIV diagnoses. Identifying contextually specific drivers of AGYW's HIV risk can help tailor HIV prevention programming to AGYW in the region.

METHODS

We pooled data from nationally representative HIV-seroprevalence surveys for sexually active AGYW in Cameroon and Côte d'Ivoire. We used latent class analysis to partition past-year sexual partnerships into discrete typologies based on 6 relationship characteristics: cohabitation, known partner HIV status, condom use at last sex, age mixing (≥5-year age disparity), transactional sex, and likelihood of having sex again. Mixture modeling with cluster-robust standard errors then assessed differences in AGYW's HIV seropositivity by partnership type.

RESULTS

Overall, 5482 AGYW reported 6389 past-year sexual partners. Four distinct partnership types emerged from LCA: Type 1 (Cohabiting, Age-Disparate Partners: ∼46%); Type 2 (Non-Cohabiting, Similar-Aged Partners: ∼15%); Type 3 (One-Off, Age-Disparate Partners: ∼30%); and Type 4 (Non-Cohabiting, Permanent, Age-Disparate Partners: ∼9%). AGYW reporting One-Off, Age-Disparate Partners and Non-Cohabiting, Permanent, Age-Disparate Partners exhibited significantly ( P < 0.05) elevated adjusted odds of HIV seropositivity relative to AGYW reporting Cohabiting, Age-Disparate Partners and Non-Cohabiting, Similar-Aged Partners, respectively.

CONCLUSIONS

AGYW reported heterogeneous partnerships that were differentially associated with HIV seropositivity, suggesting discrete relationship characteristics may confer differential HIV acquisition risks among AGYW. Delivery of HIV prevention (ie, long-acting injectable pre-exposure prophylaxis) and diagnostic (ie, HIV self-testing) technologies should be prioritized among AGYW with older, nonpermanent partners, where HIV burdens appear most pronounced.