Knowledge of HIV status, age-disparate sexual partnerships, and sexual risk behaviour among HIV positive men in South Africa: Evidence from two cross-sectional samples.

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Abstract This study investigated the association between sexual risk behaviors, self-reported HIV status, and engagement in age-disparate relationships (defined as a 5 + year age gap) among men. Two cross-sectional household surveys were conducted in the uMgungundlovu district of KwaZulu-Natal, South Africa, spanning June 2014 to June 2016. Structured questionnaires administered by trained interviewers collected data from 3801 men aged 20 to 49 years who disclosed their HIV status. The analysis revealed that HIV-positive men had decreased odds of their three most recent relationships meeting age-disparity criteria (model (3): Adjusted Odds Ratio (AOR): 0.70; 95% Confidence Interval (CI): 0.53, 0.92; model (4): AOR: 0.73; 95% CI: 0.55, 0.96). HIV-positive respondents also showed reduced likelihood of engaging in specific sexual risk behaviors, such as multiple partnerships (AOR: 0.73; 95% CI: 0.55, 0.96), inconsistent condom use (AOR: 0.38; 95% CI: 0.28, 0.52), and casual sexual relationships (AOR: 0.66; 95% CI: 0.50, 0.87). These findings underscore the critical role of men’s HIV testing in reducing HIV incidence and transmissions. The study emphasizes the need for interventions addressing barriers to HIV testing among men, including limited access, confidentiality concerns, stigma, low risk perception, and discrimination to enhance testing uptake.

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