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BACKGROUND Sub-Saharan Africa has a high rate of HIV infection, most of which is attributable to heterosexual transmission. Few attempts have been made to assess the extent of HIV transmission within marriages, and HIV-prevention efforts remain focused on abstinence and non-marital sex. We aimed to estimate the proportion of heterosexual transmission of HIV(More)
OBJECTIVE To assess the impact of Stepping Stones, a HIV prevention programme, on incidence of HIV and herpes simplex type 2 (HSV-2) and sexual behaviour. DESIGN Cluster randomised controlled trial. SETTING 70 villages (clusters) in the Eastern Cape province of South Africa. PARTICIPANTS 1360 men and 1416 women aged 15-26 years, who were mostly(More)
BACKGROUND Cross-sectional studies have shown that intimate partner violence and gender inequity in relationships are associated with increased prevalence of HIV in women. Yet temporal sequence and causality have been questioned, and few HIV prevention programmes address these issues. We assessed whether intimate partner violence and relationship power(More)
BACKGROUND There has been very little prospective research on rape perpetration among men. This paper describes the incidence and risk factors for new rape and attempted rape events among young South African men in an HIV prevention trial. METHODS We followed 1,147 men aged 15-26 years who enrolled into a cluster randomised controlled trial to evaluate(More)
BACKGROUND In sub-Saharan Africa the population prevalence of men who have sex with men (MSM) is unknown, as is the population prevalence of male-on-male sexual violence, and whether male-on-male sexual violence may relate to HIV risk. This paper describes lifetime prevalence of consensual male-male sexual behavior and male-on-male sexual violence(More)
BACKGROUND Gender-based violence and gender inequality are increasingly cited as important determinants of women's HIV risk; yet empirical research on possible connections remains limited. No study on women has yet assessed gender-based violence as a risk factor for HIV after adjustment for women's own high-risk behaviours, although these are known to be(More)
OBJECTIVE To describe the prevalence and patterns of rape perpetration in a randomly selected sample of men from the general adult population, to explore factors associated with rape and to describe how men explained their acts of rape. DESIGN Cross-sectional household study with a two- stage randomly selected sample of men. METHODS 1737 South African(More)
OBJECTIVE To investigate the associations between intimate partner violence, rape and HIV among South African men. DESIGN Cross-sectional study involving a randomly-selected sample of men. METHODS We tested hypotheses that perpetration of physical intimate partner violence and rape were associated with prevalent HIV infections in a cross-sectional(More)
BACKGROUND Sex motivated by economic exchange is a public health concern as a driver of the Sub-Saharan African HIV epidemic. We describe patterns of engagement in transactional sexual relationships and sex with women in prostitution of South African men, and suggest interpretations that advance our understanding of the phenomenon. METHODS Cross-sectional(More)
BACKGROUND Psychological factors are often neglected in HIV research, although psychological distress is common in low- to middle-income countries, such as South Africa. There is a need to deepen our understanding of the role of mental health factors in the HIV epidemic. We set out to investigate whether baseline depressive symptomatology was associated(More)