Differences in HIV risk factors between South African adolescents and adult women and their association with sexually transmitted infections

In sub-Saharan Africa, approximately 86% of HIV infections in adolescents aged 15–19 years occur among girls. Their heightened susceptibility is likely influenced by converging sociobehavioural and biological factors, although the relative contributions remain unclear. To address this, we compared known and hypothesized risk factors for HIV between cisgender adolescent girls and adult women in South Africa and evaluated the relationships between these factors and sexually transmitted infection (STI) status. This cross-sectional observational study included adolescent (n=305; 14–19 years) and adult females (n=114; 25–35 years) in two South African provinces (Western Cape (WC), KwaZulu-Natal (KZN)). Demographic and sociobehavioural data were collected by questionnaire. Colposcopy was conducted to identify cervicovaginal abnormalities, and tests for bacterial vaginosis (BV), Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis were performed.