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Vulnerability profiles and prevalence of HIV and other sexually transmitted infections among adolescent girls and young women in Ethiopia: A latent class analysis

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  • Carly A Comins
  • Katherine B Rucinski
  • Stefan Baral
  • Samuele A Abebe
  • Andargachew Mulu
  • Sheree R Schwartz

Abstract

Background: Adolescent girls and young women (AGYW) aged 15–24 years have among the highest risk for HIV and other sexually transmitted infections (STI) across sub-Saharan Africa. A latent class analysis (LCA) was conducted to identify intersecting social- and structural-level determinants of HIV/STI acquisition among AGYW in Ethiopia. Methods: AGYW were recruited from venues using time-location sampling, completing an interviewer-administered behavioral survey and biological testing for HIV, syphilis, and chlamydia. LCA was used to identify distinct groups, defined by social- and structural-level determinants of HIV/STI risk, among AGYW. Prevalence ratios (PR) and 95% confidence intervals (CI) compared differences in HIV/STI prevalence by group. Results: A total of 1,501 AGYW were enrolled across Addis Ababa (March–May 2018) and Gambella (June–July 2019). We identified three patterns of vulnerability defined by schooling status, migration history, food insecurity, orphan status, social support, and employment. We labeled these groups as “highly vulnerable” (representing ~21% of the population), “stable, out-of-school, migrated” (~42%), and “stable, in-school, never migrated” (~37%). STI prevalence was nearly two-fold higher among AGYW in the “highly vulnerable” group compared to AGYW in the “stable, in-school, never migrated” group (PR 1.93; 95% CI 1.33, 2.80). Conclusions: Characterizing patterns of vulnerability among AGYW that reflect higher-level social and structural factors can help facilitate early identification of AGYW at the highest risk of HIV/STI acquisition, thus differentiating groups of AGYW who may most benefit from targeted HIV prevention interventions during adolescence and early adulthood.

Suggested Citation

  • Carly A Comins & Katherine B Rucinski & Stefan Baral & Samuele A Abebe & Andargachew Mulu & Sheree R Schwartz, 2020. "Vulnerability profiles and prevalence of HIV and other sexually transmitted infections among adolescent girls and young women in Ethiopia: A latent class analysis," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-14, May.
  • Handle: RePEc:plo:pone00:0232598
    DOI: 10.1371/journal.pone.0232598
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    References listed on IDEAS

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    1. Arin Dutta & Andrea Wirtz & Anderson Stanciole & Robert Oelrichs & Iris Semini & Stefan Baral & Carel Pretorius & Caroline Haworth & Shannon Hader & Chris Beyrer & Farley Cleghorn, 2013. "The Global HIV Epidemics among People Who Inject Drugs," World Bank Publications - Books, The World Bank Group, number 12215.
    2. Sherbourne, Cathy Donald & Stewart, Anita L., 1991. "The MOS social support survey," Social Science & Medicine, Elsevier, vol. 32(6), pages 705-714, January.
    3. World Bank Group, 2015. "Ethiopia Urbanization Review," World Bank Publications - Reports 22979, The World Bank Group.
    4. Deanna Kerrigan & Andrea Wirtz & Stefan Baral & Michele Decker & Laura Murray & Tonia Poteat & Carel Pretorius & Susan Sherman & Mike Sweat & Iris Semini & N'Della N'Jie & Anderson Stanciole & Jenny B, 2013. "The Global HIV Epidemics among Sex Workers," World Bank Publications - Books, The World Bank Group, number 12217.
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