Brief Report: Sexual Partnership Heterogeneity and HIV Seropositivity Among Adolescent Girls and Young Women in Cameroon and Côte d'Ivoire: A Partner-Level Latent Class Analysis

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BACKGROUND: Adolescent girls' and young women's (AGYW) heightened HIV vulnerability has been understudied in West and Central Africa, where AGYW account for 1 in 5 new HIV diagnoses. Identifying contextually specific drivers of AGYW's HIV risk can help tailor HIV prevention programming to AGYW in the region. METHODS: We pooled data from nationally representative HIV-seroprevalence surveys for sexually active AGYW in Cameroon and Côte d'Ivoire. We used latent class analysis to partition past-year sexual partnerships into discrete typologies based on 6 relationship characteristics: cohabitation, known partner HIV status, condom use at last sex, age mixing (≥5-year age disparity), transactional sex, and likelihood of having sex again. Mixture modeling with cluster-robust standard errors then assessed differences in AGYW's HIV seropositivity by partnership type. RESULTS: Overall, 5482 AGYW reported 6389 past-year sexual partners. Four distinct partnership types emerged from LCA: Type 1 (Cohabiting, Age-Disparate Partners: ∼46%); Type 2 (Non-Cohabiting, Similar-Aged Partners: ∼15%); Type 3 (One-Off, Age-Disparate Partners: ∼30%); and Type 4 (Non-Cohabiting, Permanent, Age-Disparate Partners: ∼9%). AGYW reporting One-Off, Age-Disparate Partners and Non-Cohabiting, Permanent, Age-Disparate Partners exhibited significantly ( P < 0.05) elevated adjusted odds of HIV seropositivity relative to AGYW reporting Cohabiting, Age-Disparate Partners and Non-Cohabiting, Similar-Aged Partners, respectively. CONCLUSIONS: AGYW reported heterogeneous partnerships that were differentially associated with HIV seropositivity, suggesting discrete relationship characteristics may confer differential HIV acquisition risks among AGYW. Delivery of HIV prevention (ie, long-acting injectable pre-exposure prophylaxis) and diagnostic (ie, HIV self-testing) technologies should be prioritized among AGYW with older, nonpermanent partners, where HIV burdens appear most pronounced.

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