Exploring HIV risk perception and behaviour in the context of antiretroviral treatment: results from a township household survey

Figures & data

Table 1. Sociodemographic characteristics and relationships of 14–49-year-old men and women in Khayelitsha (South Africa), 2003–2004.

	Men (n=697)		Women (n=879)
	Estimate^†	95%CI^†	Estimate^†	95%CI^*
Age (mean)	28.3	(27.5–29.1)	28.7	(28.1–29.4)
Housing type (% living in brick house)	32.6	(25.2–40.9)	34.0	(26.7–42.2)
Schooling (%)
No schooling	2.4	(1.5–3.9)	1.0	(0.5–1.9)
Primary school only	20.8	(17.2–25.0)	15.5	(12.9–18.6)
Secondary school below grade 10	23.5	(20.4–26.9)	20.1	(17.4–23.2)
Grade 10	25.6	(22.6–28.9)	34.3	(31.1–37.7)
Matric (school leaving)	26.0	(22.4–29.9)	25.1	(21.9–28.5)
Tertiary	1.6	(1.0–2.7)	4.0	(2.6–5.9)
Literacy (literate)	90.4	(87.6–92.6)	97.7	(96.3–98.6)
Place of birth (%)
Khayelitsha	5.3	(3.8–7.5)	4.8	(3.5–6.6)
Cape Town	12.3	(9.4–16.1)	14.7	(11.5–18.5)
Western Cape	4.8	(3.3–7.0)	3.1	(2.0–4.8)
Eastern Cape	77.3	(72.2–81.8)	77.4	(73.0–81.3)
Other	0.2	(0.0–1.3)	0
Time lived in Khayelitsha (%)
Less than 1 year	7.3	(5.6–9.3)	5.6	(4.3–7.3)
1–5 years	18.9	(15.9–22.3)	18.9	(16.0–22.1)
5–10 years	22.3	(19.2–25.9)	25.0	(22.1–28.1)
More than 10 years	51.5	(47.7–55.4)	50.4	(47.0–53.9)
Employment status (%)
Full-time employed	33.3	(29.4–37.4)	17.1	(14.3–20.2)
Irregular employment	13.5	(11.2–16.3)	9.1	(7.3–11.4)
Self-employed or informal sector	3.9	(2.6–5.7)	7.9	(6.0–10.3)
Unemployed and job-seeking	27.8	(24.2–31.7)	44.9	(41.1–48.6)
Student	20.9	(17.8–24.2)	18.1	(15.5–21.1)
Other	0.6	(0.3–1.4)	3.0	(2.0– 4.3)
Income source (%)
Family and friends	46.7	(42.5–51.0)	63.8	(60.5–67.0)
Employment	51.8	(47.4–56.2)	30.8	(27.4–34.5)
Grant	2.3	(1.4–3.7)	15.5	(13.4–18.0)
Other or none	2.8	(1.8–4.4)	5.7	(4.2–7.6)
Circumcised (%)	74.9	(71.1–78.4)
^† Weighted mean or proportion adjusted for cluster as primary sampling unit.

Table 2. Sexual risk factors for HIV/AIDS of 14–49-year-old men and women in Khayelitsha (South Africa), 2003–2004.

	Men (n=697)		Women (n=879)
	Estimate^†	95%CI^†	Estimate^†	95%CI^†
Sexually active (%)	92.6	(90.4–94.4)	94.0	(92.4–95.2)
Age at sexual debut (mean)	15.3	(14.9–15.7)	16.5	(16.2–16.8)
Relationships (%)
Not in relationship	17.3	(14.7–20.1)	18.2	(15.7–20.9)
In relationship, but partner not living in Khayelitsha.	13.5	(11.0–16.4)	14.0	(11.8–16.6)
In relationship, with partner in Khayelitsha.	37.9	(33.9–42.0)	29.8	(27.1–32.7)
Living together with partner	31.4	(27.5–35.5)	38.0	(34.4–41.8)
Age difference with partner^‡ (mean)	4.4	(4.1–4.9)	−5.1	(−5.5– −4.7)
Used a condom last time with partner^‡ (%)	43.7	(39.0–48.4)	34.2	(30.1–38.5)
Generally use condom with partner^‡ (%)
Never	46.2	(41.3–51.2)	51.5	(47.3–55.6)
Sometimes	22.4	(18.2–27.2)	22.5	(19.3–26.0)
Always	31.4	(27.1–36.1)	26.1	(22.3–30.2)
Lifetime number of sexual partners (%)
None	7.8	(6.0–10.3)	6.3	(5.0–7.9)
1	3.4	(2.1–5.5)	14.7	(12.0–17.7)
2–4	26.9	(23.5–30.6)	58.4	(55.3–61.5)
5–9	28.5	(25.1–32.2)	16.4	(14.0–19.0)
10–19	20.2	(17.1–23.7)	3.9	(2.8–5.4)
20 or more	13.2	(10.6–16.3)	0.3	(0.1–1.0)
Number of sex partners apart from regular partner during the last 12 months ^‡ (%)
None	71.1	(67.2–74.8)	91.7	(89.6–93.3)
1	16.1	(13.2–19.4)	7.5	(6.0–9.3)
2–4	10.9	(8.8–13.4)	0.8	(0.3–2.1)
5–9	1.6	(0.8–3.1)	0
10 or more	0.3	(0.1–1.2)	0
^† Weighted mean or proportion adjusted for cluster as primary sampling unit; CI: Confidence interval.
^‡ For those with regular sexual partner.

Table 3. Knowledge about HIV/AIDS transmission and prevention in 14–49-year-old men and women in Khayelitsha, 2003–2004.

	Men (n = 697)		Women (n=879)
	%^†	95%CI^†	%^†	95%CI^†
Knows someone with HIV	54.0	(49.5–58.5)	62.7	(59.1–66.2)
Knows of infected family members	9.7	(7.6–12.1)	18.5	(15.9–21.4)
Knows of infected friends/colleagues	14.7	(11.8–18.3)	27.6	(24.3–31.1)
Cared for someone with HIV	6.0	(4.1–8.6)	15.0	(12.6–17.9)
Knows someone who died from HIV	72.7	(68.8–76.4)	76.0	(72.8–78.9)
Knows of a family member who died from HIV	12.4	(9.9–15.4)	22.9	(20.3–25.6)
Reported modes of contracting HIV
Unprotected sex	95.3	(93.5–96.7)	94.7	(93.0–96.0)
Blood contact	81.4	(78.2–84.3)	84.4	(81.7–86.9)
MTCT	11.1	(8.6–14.1)	49.5	(44.9–54.0)
Dirty needles	23.5	(20.0–27.4)	60.2	(54.9–65.1)
Razorblades	22.4	(19.5–25.6)	52.7	(47.6–57.8)
Toothbrush	15.5	(12.8–18.6)	49.0	(44.3–53.6)
Punishment	0.6	(0.3–1.5)	25.5	(21.6–29.7)
Foreigners	5.7	(4.2–7.8)	32.6	(28.7–36.9)
Reported ways of preventing HIV
Condoms	90.1	(87.2–92.5)	97.3	(95.9–98.1)
Abstinence	35.0	(31.6–38.6)	38.2	(34.6–42.0)
Being faithful	39.2	(35.4–43.3)	23.2	(20.3–26.3)
PMTCT	3.3	(2.0– 5.3)	18.9	(16.1–22.0)
Behaving properly	14.0	(10.9–17.9)	21.0	(17.7–24.7)
Believes one can visually tell if someone is HIV-infected	21.9	(18.6–25.6)	14.4	(12.0–17.2)
Reported symptoms/signs of HIV/AIDS^‡
Weight loss	79.2	(75.8–82.2)	73.6	(69.5–77.3)
Diarrhoea	28.6	(24.9–32.7)	31.3	(28.1–34.7)
Inability to walk	29.0	(25.9–32.4)	21.1	(18.5–24.0)
Hair loss	44.2	(39.6–48.9)	30.4	(27.4–33.7)
Red lips	36.2	(32.2–40.4)	20.3	(17.4–23.5)
^† Weighted proportion adjusted for cluster as primary sampling unit; CI: Confidence interval.
^‡ All answers occurring in at least approximately 20% of respondents for either gender.

Table 4a. Condom use in 14–49-year-old, sexually active men and women in Khayelitsha (South Africa), 2003–2004.

	Men (n=648)		Women (n=823)
	%^†	95%CI^†	%^†	95%CI^†
Condom use in any last sexual contact	40.7	(36.4–45.1)	32.6	(28.9–36.5)
In 14–19 year-old respondents	67.6	(53.4–79.1)	56.7	(44.8–67.9)
In 20–29 year-old respondents	51.6	(45.1–58.1)	35.7	(29.9–42.0)
In 30–39 year-old respondents	25.9	(19.9–32.9)	27.8	(22.0–34.4)
In 40–49 year-old respondents	21.0	(14.0–30.5)	20.6	(14.6–28.2)
Reason for condom use^‡
To protect myself against HIV	49.3	(45.1–53.5)	32.8	(29.7–36.0)
To protect my partner against HIV	21.1	(18.0–24.6)	9.1	(7.1–11.7)
To protect against STI's	35.7	(32.0–39.7)	32.3	(28.8–36.0)
To prevent pregnancy	20.3	(17.3–23.5)	22.2	(18.8–26.0)
Reason for not using condoms^‡
Don't enjoy sex with them	13.6	(11.3–16.2)	1.0	(0.5 –1.9)
Partner is faithful	37.2	(32.9–41.8)	23.2	(19.6–27.2)
Partner refuses	2.5	(1.5 –4.2)	27.2	(24.0–30.6)
Buys condoms	7.3	(5.1–10.4)	9.8	(7.2–13.3)
Place for getting condoms for free^‡
Public sector clinic	52.5	(48.3–56.6)	46.2	(42.2–50.3)
Ever wanted to but did not use condoms	18.4	(15.0–22.3)	28.8	(25.5–32.4)
Reasons for not using condoms^‡,*
None available	15.0	(10.5–21.1)	7.7	(5.1–11.4)
Alcohol	18.3	(13.8–23.8)	0.8	(0.2–3.0)
Partner refused	14.8	(10.1–21.2)	72.1	(65.6–77.8)
^† Weighted proportion adjusted for cluster as primary sampling unit; CI: Confidence interval.
^‡ All answers occurring in at least 10% of respondents for either gender.
* Responses to this question are based on 105 men and 224 women who answered the preceding question in the affirmative.

Table 4b. Multiple logistic regression model for association with condom use during last sexual contact in 14–49-year-old, sexually active men and women in Khayelitsha (South Africa), 2003–2004.

Men
Factor	Category	OR^†	95%CI^†	P-value^†
Age	Slope (OR/yr) for < 35 years	0.96	(0.92–0.99)	0.025
	Slope (OR/yr) for ≥ 35 years	1.04	(0.96–1.13)	0.310
Type of relationship	Not in relationship	2.31	(1.20–4.46)	< 0.001
	In relationship, but partner not living in Khayelitsha.	4.29	(2.29–8.07)
	In relationship of < 1 yr, with partner in Khayelitsha	9.48	(4.64–19.34)
	In relationship of ≥ 1 yr, with partner in Khayelitsha	6.14	(3.41–11.04)
	Living together with partner	Reference category
Education	Secondary school or better	1.33	(0.81–2.18)	0.260
Knowledge route of transmission
	Quotes 2 correct items	1.76	(1.13–2.74)	0.012
Knows that condoms prevent HIV transmission
	Yes	10.28	(3.45–30.63)	< 0.001
Knows that abstinence prevents HIV transmission
	Yes	1.50	(1.00–2.24)	0.048
Talks about HIV/AIDS
	With friends	1.68	(1.03–2.76)	0.038
Women
Factor	Category	OR^†	95%CI^†	P-value^†
Age	Slope (OR/yr) for < 25 years	0.89	(0.83–0.96)	0.005
	Slope (OR/yr) for ≥ 25 years	1.00	(0.97–1.03)	0.835
Type of relationship	Not in relationship	2.54	(1.47–4.37)	< 0.001
	In relationship, but partner not living in Khayelitsha.	3.82	(2.27–6.43)
	In relationship of < 1 yr, with partner in Khayelitsha	7.19	(3.83–13.52)
	In relationship of ≥ 1 yr, with partner in Khayelitsha	2.77	(1.78–4.32)
	Living together with partner	Reference category
Education	Secondary school or better	1.93	(1.20–3.12)	0.007
Housing type	One room house	0.55	(0.32–0.94)	0.029
Knows somebody who died of AIDS
	Yes	1.67	(1.08–2.59)	0.022
Talks about HIV/AIDS
	With friends, family or partner	1.60	(0.94–2.74)	0.086^‡
Knowledge of ART	Knows ART needs to be taken for ever	2.09	(1.24–3.53)	0.042
	Knows ART but not that it needs to be taken for ever	1.17	(0.79–1.74)
	Has not heard of ART	Reference category
^† Adjusted odds-ratio's (OR), 95% confidence interval (CI) and p-values from multiple logistic regression model.

Table 5a. Uptake of VCT and knowledge of interventions in 14–49-year-old men and women in Khayelitsha (South Africa), 2003–2004.

	Men (n=697)		Women (n=879)
	%^†	95%CI^†	%^†	95%CI^†
Know where one can be tested for HIV	77.9	(74.4–81.1)	96.5	(95.1–97.5)
Ever tested for HIV	28.0	(25.1–31.1)	53.3	(49.1–57.5)
In 14–19 year-old respondents	5.7	(2.8–11.5)	24.1	(17.3–32.6)
In 20–29 year-old respondents	28.9	(23.7–34.7)	61.9	(55.6–67.7)
In 30–39 year-old respondents	42.3	(34.5–50.5)	62.5	(56.0–68.5)
In 40–49 year-old respondents	27.8	(19.1–38.7)	41.5	(32.8–50.7)
HIV status^‡
Preferred not to disclose	4.1	(2.0–8.1)	0.8	(0.3– 2.3)
HIV-positive	1.1	(0.3–4.4)	6.1	(4.3–8.5)
HIV-negative	94.8	(90.5–97.2)	93.1	(90.6–95.1)
Reason for testing^‡
Told by health staff	7.9	(4.2–14.6)	11.4	(8.5–15.2)
MTCT	2.3	(0.9–6.0)	44.9	(40.1–49.7)
Was sick	25.4	(19.5–32.4)	18.2	(14.4–22.7)
Wanted to know status	51.2	(43.0–59.3)	39.3	(34.8–44.0)
Reason for not testing^¥
I am afraid of the result	28.5	(24.2–33.3)	49.1	(43.7–54.4)
I do not feel at risk	31.9	(27.0–37.3)	27.1	(22.8–31.9)
I am not sexually active	14.3	(11.4–17.7)	13.4	(10.6–17.0)
I do not know where to test	18.7	(15.3–22.6)	3.1	(1.7–5.5)
Knows someone who had tested	47.2	(43.3–51.1)	48.9	(45.2–52.7)
Talks about HIV with friends	82.3	(79.4–84.8)	74.3	(71.1–77.4)
Talks about HIV with partner	75.1	(71.7–78.3)	77.0	(73.9–79.7)
Talks about HIV with other relatives	55.9	(51.6–60.1)	52.1	(48.8–55.4)
Heard of the Treatment Action Campaign	22.8	(19.7–26.2)	36.5	(33.2–39.9)
Believes HIV can be cured	8.1	(5.9–11.2)	6.7	(5.0– 8.9)
Knows that TB can be cured	97.5	(95.8–98.5)	97.2	(95.7–98.2)
Heard of ART	26.9	(23.6–30.5)	43.3	(39.2–47.6)
Knows someone on ART^¶	14.1	(9.2–21.1)	21.6	(17.2–26.9)
Knows where to get ART^¶	68.9	(60.9–75.9)	73.4	(68.9–77.5)
Source of information on HIV ^¶
Newspaper	23.3	(17.8–29.9)	8.1	(5.6–11.5)
Radio	61.1	(52.0–69.4)	42.1	(36.9–47.5)
Church	0.6	(0.1–2.3)	0.4	(0.1–1.8)
Television	50.3	(42.7–58.0)	41.3	(35.6–47.1)
School	5.0	(2.7–8.9)	7.6	(5.2–11.0)
Treatment Action Campaign	4.8	(2.1–10.4)	5.6	(3.7–8.4)
Clinic	10.9	(6.9–16.8)	31.9	(26.8–37.4)
Other	8.2	(4.4–14.9)	13.6	(10.3–17.8)
^† Weighted proportion adjusted for cluster as primary sampling unit; CI: Confidence interval. ART: antiretroviral therapy; PMTCT: Prevention of mother-to-child transmission of HIV.
^‡ For those who tested.
^¥ For those who did not test.
^¶ For those who have heard of ARVs.

Table 5b. Multiple logistic regression model for association with VCT uptake in 14–49-year-old, sexually active men and women in Khayelitsha (South Africa), 2003–2004.

Men
Factor	Category	OR^†	95%CI^†	P-value^†
Age	Slope (OR/yr) for < 30 years	1.17	(1.09–1.26)	<0.001
	Slope (OR/yr) for ≥30 years	0.97	(0.92–1.03)	0.318
Type of relationship	Not in relationship	1.10	(0.72–2.68)	0.081
	In relationship, but partner not living in Khayelitsha	1.39	(2.29–8.07)
	In relationship of <1 yr, with partner in Khayelitsha	2.33	(1.10–4.94)
	In relationship of ≥1 yr, with partner in Khayelitsha	2.14	(1.12–4.08)
	Living together with partner	Reference category
Education	Secondary school or better	1.20	(0.72–2.00)	0.497
Employment Status	Retired, disabled, homemaker	0.24	(0.06–1.04)
	Unemployed and job-seeking	0.82	(0.49–1.40)
	Irregular, self or informal employed	0.49	(0.29–0.84)	0.040
	Student	0.54	(0.23–1.27)
	Full-time employed	Reference category
Age difference with partner
	Female partner > 5 yrs younger	0.52	(0.32–0.83)	0.006
Knows someone who has tested
	Yes, partner	9.57	(5.21–17.57)	< 0.001
	Yes, somebody other than partner	3.31	(2.13–5.14)
	Knows nobody who has tested	Reference category
Knows that condoms prevent HIV transmission
	Yes	2.26	(1.12–4.55)	0.022
Women
Age	Slope (OR/yr) for < 30 years	1.03	(0.98–1.09)	0.188
	Slope (OR/yr) for ≥30 years	0.91	(0.88–0.95)	< 0.001
Type of relationship	Not in relationship	0.94	(0.56–1.57)	0.189
	In relationship, but partner not living in Khayelitsha	0.56	(0.33–0.96)
	In relationship of < 1 yr, with partner in Khayelitsha	0.49	(0.19–1.31)
	In relationship of ≥ 1 yr, with partner in Khayelitsha	0.71	(0.45–1.12)
	Living together with partner	Reference category
Education	Secondary school or better	1.24	(0.78–1.98)	0.372
Employment status	At home, retired or disabled	3.80	(1.38–10.46)	< 0.001
	Unemployed and job seeking	1.72	(1.11–2.65)
	Irregular, self or informal	1.12	(0.63–1.98)
	Student	0.60	(0.32–1.14)
	Full time employed	Reference category
Place of Birth	Born in Eastern-Cape	0.61	(0.40–0.94)	0.024
Age difference with partner
	Male partner > 5 yrs older	1.60	(1.12–2.28)	0.010
Has knowledge of ART	Knows somebody on ART	2.59	(1.36–4.94)	0.020
	Knows of ART, but no one on ART	1.30	(0.92–1.85)
	Has not heard of ART	Reference category
Knows someone who has tested
	Yes, partner	2.52	(1.28–4.99)	0.008
	Yes, other than partner	0.86	(0.60–1.23)
	Not knowing anyone who has tested	Reference category
Has knowledge of PMTCT
	Yes	4.16	(2.62–6.61)	< 0.001
Knows that condoms prevent HIV transmission
	Yes	2.58	(1.12–5.93)	0.026
Discusses HIV/AIDS	With friends, family or partner	1.92	(1.12–3.31)	0.018
Has cared for someone with HIV
	Yes	2.11	(1.23–3.62)	0.007
^† Adjusted odds-ratio's (OR), 95% confidence interval (CI) and p-values from multiple logistic regression model.ART: antirotroviral therapy; PMTCT: prevention of mother-to-child transmission,