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Effects of Early Social Bonds on Adolescent Trajectories of Sexual Risk Behaviors Among South African Girls

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Abstract

The goal of this manuscript is to advance HIV risk behavior prevention efforts for South African adolescent girls by identifying distinct trajectory patterns across multiple behavioral domains for adolescent and young adults. We draw from a sample of N = 1070 adolescent girls from South Africa who were between the ages of 13–15 at baseline. Participants were followed across 6 waves of data collection between 2011 and 2019. We focus on predicting trajectories between ages 15 and 21. All participants were HIV negative and had not experienced sexual debut at baseline. We examine group-based multi-variable trajectories across several known HIV risk behaviors: earlier age of sexual debut, engaging in unprotected sex, engaging in transactional sex, earlier age at first pregnancy, and exposure to physical IPV. We characterized three prototypical joint trajectories: abstainers (54%), early unprotected sex (36%), and high-risk sexually active (11%). We then predicted membership based on the following baseline risk and protective factors: household expenditures, bonding to school, parental monitoring, number of close friends, and community engagement. We found that school bonding and parental monitoring were the strongest predictor of sexual risk, and that, among those in both the early unprotected sex and high-risk groups, risky behaviors like unprotected and transactional sex most frequently occurred early in adolescence. These findings suggest that interventions should target girls early in adolescence, and that interventions focused at improving school bonding and promoting parental involvement may be most effective at preventing risky sexual behavior.

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Acknowledgements

NLB was supported by the National Institute of Allergy and Infectious Diseases (T32 AI00700140). The HIV Prevention Trials Network is funded by the National Institute of Allergy and Infectious Diseases (UM1AI068619, UM1AI068613, and UM1AI1068617), with co-funding from the National Institute of Mental Health and the National Institute on Drug Abuse, all components of the US National Institutes of Health. This work was also supported by NIMH(R01MH087118) and the Carolina Population Center and its NIH Center Grant (P2C HD050924).

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Authors and Affiliations

  1. Center for Communication Science, RTI International, Durham, NC, USA

    Nisha C. Gottfredson, Nivedita L. Bhushan & H. Luz McNaughton Reyes

  2. Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, USA

    Audrey E. Pettifor

  3. MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), University of Witwatersrand, Johannesburg, South Africa

    Kathleen Kahn

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  1. Nisha C. Gottfredson
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AP and KK collected data from the parent study. NG analyzed the data. NG and NB wrote the first draft of the manuscript. All authors provided input on analyses and manuscript text.

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Correspondence to Nisha C. Gottfredson.

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Gottfredson, N.C., Bhushan, N.L., Reyes, H.L.M. et al. Effects of Early Social Bonds on Adolescent Trajectories of Sexual Risk Behaviors Among South African Girls. AIDS Behav 26, 1173–1182 (2022). https://doi.org/10.1007/s10461-021-03472-w

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