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Cited by 8Adolescent Sexual and Reproductive HealthHIV/AIDS Research and InterventionsFamily Dynamics and Relationships

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Associations of Father and Adult Male Presence with First Pregnancy and HIV Infection: Longitudinal Evidence from Adolescent Girls and Young Women in Rural South Africa (HPTN 068)

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Albert, Lisa M., Edwards, Jess, Pence, Brian, Speizer, Ilene S., Hillis, Susan, Kahn, Kathleen, Gómez-Olivé, F. Xavier, Wagner, Ryan G., Twine, Rhian, Pettifor, Audrey·2021·AIDS and Behavior
DOI 10.1007/s10461-020-03147-yPMC PMC8580262
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Abstract

This study, a secondary analysis of the HPTN 068 randomized control trial, aimed to quantify the association of father and male presence with HIV incidence and first pregnancy among 2533 school-going adolescent girls and young women (AGYW) in rural South Africa participating in the trial between March 2011 and April 2017. Participants' ages ranged from 13-20 years at study enrollment and 17-25 at the post-intervention visit. HIV and pregnancy incidence rates were calculated for each level of the exposure variables using Poisson regression, adjusted for age using restricted quadratic spline variables, and, in the case of pregnancy, also adjusted for whether the household received a social grant. Our study found that AGYW whose fathers were deceased and adult males were absent from the household were most at risk for incidence of first pregnancy and HIV (pregnancy: aIRR = 1.30, Wald 95% CI 1.05, 1.61, Wald chi-square p = 0.016; HIV: aIRR = 1.27, Wald 95% CI 0.84, 1.91, Wald chi-square p = 0.263) as compared to AGYW whose biological fathers resided with them. For AGYW whose fathers were deceased, having other adult males present as household members seemed to attenuate the incidence (pregnancy: aIRR = 0.92, Wald 95% CI 0.74, 1.15, Wald chi-square p = 0.462; HIV: aIRR = 0.90, Wald 95% CI 0.58, 1.39, Wald chi-square p = 0.623) such that it was similar, and therefore not statistically significantly different, to AGYW whose fathers were present in the household.

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  • Paternally orphaned children are more likely than non-orphans to experience sexual violence, potentially linked to household economic vulnerability.

    “Paternally orphaned children are more likely than non-orphans to experience sexual violence, potentially linked to household economic vulnerability.8, 26”

    From Global minimum estimates of children affected by COVID-19-associated orphanhood and deaths of caregivers: a modelling study (2021) · cites this paper as [26]

    The Discussion (page not provided) reports an association between paternal absence and sexual violence among adolescent girls, citing a pooled analysis, and notes slightly higher baseline forced-sex reports among girls with no adult male at home. It does not establish the claimed comparison between paternally orphaned children and non-orphans: an absent father may be alive. The Discussion raises reduced socioeconomic status as a possible pathway for pregnancy risk, but does not link household economic vulnerability specifically to sexual violence. (LLM, conf=0.86)

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Metadata

Authors
Albert, L. M., Edwards, J., Pence, B., Speizer, I. S., Hillis, S., Kahn, K., Gómez-Olivé, F. X., Wagner, R. G., Twine, R., & Pettifor, A.
Affiliations
  • University of North Carolina at Chapel Hill (US)
  • Centers for Disease Control and Prevention (US)
  • University of the Witwatersrand (ZA)
Corresponding author
Albert, Lisa M.
ORCID
Venue
AIDS and Behavior
Publisher
Springer Science and Business Media LLC
Published
2021-01-08
Volume
25
Issue
7
Pages
2177-2194
ISSN
  • 1090-7165 (ISSN-L)
  • 1573-3254
DOI
10.1007/s10461-020-03147-y
PMC
PMC8580262
OpenAlex
W3119754996
Cited by
8
References
2
Citations by year
2025: 1 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 1
FWCI
1.97
Type
journal article
Language
en
Open access
Licence
Locations
  • AIDS and Behavior (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute of Allergy and Infectious Diseases (UM1AI068619, Award Number 5R01MH087118-02)
  • National Institute of Mental Health (UM1AI068617)
  • National Institute on Drug Abuse (UM1AI068613)
  • National Institute on Alcohol Abuse and Alcoholism (R24 HD050924)
  • Wellcome Trust (058893/Z/99/A, 069683/Z/02/Z, 085477/Z/08/Z, 085477/B/08/Z)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Adolescent Sexual and Reproductive Health
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Social Sciences › Demography › Family Dynamics and Relationships
Keywords
adolescent girls and young women, HIV incidence, first pregnancy, father presence, father absence, household composition, social grants, rural South Africa, HPTN 068
MeSH terms
Adolescent, Adult, Fathers, Female, Humans, Male, Pregnancy, Rural Population, South Africa, HIV Infections, Incidence, Young Adult

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