This book provides an overview of the current epidemiology of the HIV epidemic among young people in Eastern and Southern Africa (ESA) and examines the efforts to confront and reduce the high level of new HIV infections amongst young people. Taking a multi-dimensional approach to prevention, the contributors discuss the many challenges facing these efforts, in view of the slow progress in curbing the incidence of HIV amongst young people, focusing particularly on the structural and social drivers of HIV. Through an examination of these issues, chapters in this book provide valuable insights on how to mitigate HIV risk among young people and what can be regarded as the catalysts to mounting credible policy and programmatic responses required to achieve epidemic control in the region. The contributors draw on examples from a range of primary and secondary data sources to illustrate promising practices and challenges in HIV prevention, demonstrating links between conceptual approaches to prevention and lessons learnt from implementation projects in the region. Bringing together social scientists and public health experts who are actively engaged in finding effective solutions, the book discusses ‘which interventions works’, ‘why they work’, and the limitations and gaps in our knowledge to curb the pandemic amongst young people. As such it is an important read for researchers focusing on HIV/AIDS and public health. The Open Access version of this book, available at https://www.taylorfrancis.com/books/e/10.4324/9780429462818 has been made available under a Creative Commons Attribution-Non Commercial-No Derivatives 4.0 license.

The AIDS epidemic in Sub-Saharan Africa continues to affect all facets of life throughout the subcontinent. Deaths related to AIDS have driven down the life expectancy rate of residents in Zambia, Kenya, and Uganda with far-reaching implications. This book details the current state of the AIDS epidemic in Africa and what is known about the behaviors that contribute to the transmission of the HIV infection. It lays out what research is needed and what is necessary to design more effective prevention programs.

This second edition of the book provides up-to-date information on new drugs, new proven HIV prevention interventions, a new chapter on positive prevention, and current HIV epidemiology. This definitive text covers all aspects of HIV/AIDS in South Africa, from basic science to medicine, sociology, economics and politics. It has been written by a highly respected team of South African HIV/AIDS experts and provides a thoroughly researched account of the epidemic in the region.

Statement of the Problem: Of the 19.4 million people living with HIV in eastern and southern Africa in 2016, 59% of them were women and girls. The elevated risk of acquiring HIV is due to many factors that drive disempowerment in heterosexual relationships and HIV risk behaviors. Few studies employ a comprehensive framework to examine divisions between men and women and HIV risk behaviors in an African context. Purpose: To assess the association between empowerment indicators and attitudes based on the Theory of Gender and Power and HIV risk behaviors in couples by country. Methods: In the first study, we defined the women's empowerment predictor as household decision-making, female economic independence, wife-beating attitudes, and age and educational differences between partners. The outcomes of interest were infidelity by the man and self-efficacy for a woman to initiate safe sex and refuse sex. In the second study, we analyzed associations between attitudes towards women's empowerment (household decision-making and wife-beating attitudes) and the same HIV risk behaviors. Overall, we conducted cross-sectional analyses, using logistic regression, of couples aged 15-64 in countries with Demographic and Health Survey data and high HIV prevalence: Malawi, Namibia, Zambia, and Zimbabwe. Results: Female economic independence, household decision-making involvement, and rejecting all reasons for wife-beating were strong indicators of high levels of empowerment. High versus low women's empowerment was associated with an increased likelihood of safer sex negotiation among women in Malawi (AOR=1.57, 95% CI: 1.08-2.00) and Zambia (AOR=1.60, 95% CI:1.34-1.91), and sex refusal among women in Malawi (AOR=1.62, 95% CI: 1.29-2.04) and Zimbabwe (AOR=1.29, 95% CI:1.04-1.59). Empowerment attitude discordance was associated with infidelity among men in Zambia and Zimbabwe (AOR=1.94, 95% CI: 1.39-2.40; AOR=1.88, 95% CI: 1.27-2.77), and a decreased likelihood of safer sex negotiation in Zambia (AOR=0.58, 95% CI: 0.42-0.81) and of sex refusal in Malawi (AOR=0.66, 95% CI: 0.45-0.97), Zambia, (AOR=0.74, 95% CI: 0.58-0.95), and Zimbabwe (AOR=0.72, 95% CI: 0.57-0.91). Conclusions: Empowerment indicators and attitudes drive relationship dynamics, sexual power, and sexual behavior in African couples. Policymakers should incorporate these factors to enhance programs that facilitate empowerment for HIV prevention.