Sexual and reproductive health risk behaviours among South African university students: results from a representative campus-wide survey

Susie HoffmanHIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, USA;Department of Epidemiology, Mailman School of Public Health at Columbia University, New York, USACorrespondence[email protected]

Michael LevasseurDepartment of Epidemiology, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA

Joanne E. MantellHIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, USA

Mags BeksinskaDepartment of Obstetrics and Gynaecology, Faculty of Health Sciences, Maternal, Adolescent and Child Health Research Unit (MatCH Research Unit), University of the Witwatersrand, Durban, South Africa

Zonke MabudeDepartment of Obstetrics and Gynaecology, Faculty of Health Sciences, Maternal, Adolescent and Child Health Research Unit (MatCH Research Unit), University of the Witwatersrand, Durban, South Africa

Claudia NgoloyiDepartment of Obstetrics and Gynaecology, Faculty of Health Sciences, Maternal, Adolescent and Child Health Research Unit (MatCH Research Unit), University of the Witwatersrand, Durban, South Africa

Elizabeth A. KelvinEpidemiology and Biostatistics Program, School of Urban Public Health, Hunter College & The CUNY School of Public Health, City University of New York, New York, USA

Theresa ExnerHIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, USA

Cheng-Shiun LeuHIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, USA;Department of Biostatistics, Mailman School of Public Health at Columbia University, New York, New York, USA

Lavanya PillayDepartment of Obstetrics and Gynaecology, Faculty of Health Sciences, Maternal, Adolescent and Child Health Research Unit (MatCH Research Unit), University of the Witwatersrand, Durban, South Africa

Jennifer A. SmitDepartment of Obstetrics and Gynaecology, Faculty of Health Sciences, Maternal, Adolescent and Child Health Research Unit (MatCH Research Unit), University of the Witwatersrand, Durban, South Africa;Discipline of Pharmaceutical Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

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Abstract

Among South African university students, HIV prevalence is lower than in age-peers, but at 3.8% it is not negligible. We examined prevalence of factors potentially associated with HIV risk, focusing on partnership characteristics and consistent condom use. We hypothesised that contraceptive-related factors, for example, desire to prevent pregnancy and not using hormonal contraceptives, would be positively associated with consistent condom use. Data were drawn from a representative interviewer-administered survey of 2nd to 4th year students conducted during registration at a university campus in KwaZulu-Natal. Of 576 students, 218 (83 women, 135 men) reported vaginal intercourse in the past 2 months. Of these, 7% of women and 43% of men reported past-year concurrent partnerships, and 24% knew/ suspected partner non-monogamy. Although reported condom use at last intercourse was 90%, 2-month consistent use was 53% (women) and 73% (men). Reported hormonal contraception use was low (women: 36.8%; men: 16.7%), and 68% used condoms for dual protection. In gender-stratified multivariable analyses, consistent condom use was higher for men who reported their partner did not use (vs. used) hormonal contraception (aOR = 5.84; 95%CI = 2.71, 12.57; p < 0.001) and who reported using condoms for dual protection (vs. single protection) (aOR = 2.46; 95%CI = 1.43, 4.25; p = 0.001). No contraception-related factors were associated with consistent condom use among women. Sexual partnership characteristics potentially place sexually active university students at high HIV risk and should be investigated further. Among men, but not women, contraceptive concerns were associated with consistent condom use. Promoting condoms for dual protection may resonate with students and should be continued.

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