Grant: Doctoral: Vanier Canada Graduate Scholarships

On average 2,000 young women (YW) in South Africa acquire HIV every week, representing the highest new infection rates globally. Emerging research has begun to examine and act upon the multiple-intersecting factors that place YW at increased risk for HIV. High-levels of sexually transmitted infections (STIs) and immature vaginal lining make YW more biologically susceptible to HIV. HIV risk for YW is also elevated due to social factors. Our previous work has found that YW experience high-levels of sexual relationship power inequity (SRPI), which compromises their agency to negotiate safe sex, impacts mental health, and heightens their risk of STIs/HIV. Evidence is needed to examine how socio-relational factors intersect with biological risk. As such, this proposed research seeks to examine and explore measures of SRPI and how SRPI influences biological, relational, and structural HIV vulnerabilities for YW growing-up within HIV hyper-endemic settings. Using prospective data from a youth-centered sexual reproductive health study conducted among South African youth aged 16-24 over an 18-month period, the objectives of this proposal are to 1) examine how SRPI influences STI treatment uptake, partner notification and STI incidence, 2) explore the pathway from SRPI to heightened biological susceptibility through it's influence on markers of stress and inflammation and 3) explore how SRPI is measured, conceived and influences the sexual decision-making practices and health-seeking behaviours of young men and women. As international targets aim to achieve an AIDS-free generation by 2030, this research merging biological and socio-behavioural data to examine the factors impacting heightened HIV-risk for YW living at the epicentre of the HIV epidemic is extremely timely. Moreover, the proposed research is in line with and can be used to inform the Canadian governments new feminist approach to international aid that prioritizes advancing and promoting equal rights for women.