Demographic

14.4 HIV PREVALENCE AND MALE CIRCUMCISIONAs discussed in Chapter 12, malecircumcision is considered to have a protectiveeffect for HIV infection, in partbecause of physiological differences thatincrease the susceptibility to HIV infectionamong uncircumcised men. As Table 14.10shows, the relationship between HIV prevalenceand circumcision status is not in theexpected direction. Circumcised men have aslightly higher HIV infection rate than menwho are not circumcised (22 percent comparedwith 20 percent). It is worth noting thatthe relationship between male circumcisionand HIV infection may be confounded by thefact that the circumcision may not involve thefull removal of the foreskin, which providespartial protection. As is the case with otherfindings, additional analysis is needed todetermine if this lack of a relationship betweenmale circumcision and HIV infectionis a result of confounding factors or representsthe true situation.14.5 HIV PREVALENCE AMONG YOUTHTable 14.10 HIV prevalence by male circumcisionAmong men age 15-49 who were tested for HIV, the percentage HIVpositive by whether circumcised or not, according to backgroundcharacteristics, Swaziland 2006-07BackgroundcharacteristicCircumcisedPercentageHIVpositive 1 NumberNot circumcisedPercentageHIVpositive 1 NumberAge15-19 (0.0) 53 2.0 1,21820-24 (8.8) 53 12.6 72725-29 (26.2) 46 27.9 50730-34 (26.5) 39 45.7 34135-39 45.3 61 44.8 26040-44 (22.8) 29 43.2 20145-49 (22.4) 26 28.5 203ResidenceUrban 24.5 140 25.7 930Rural 19.6 165 17.2 2,527RegionHhohho 23.2 92 23.1 909Manzini 21.7 113 18.1 1,110Shiselweni (15.2) 51 16.2 712Lubombo (26.3) 50 20.6 726EducationNo education (30.9) 29 31.1 256Primary 18.2 97 18.1 1,240Secondary 25.4 139 18.1 1,718More than secondary (12.3) 41 25.0 243Young people living with HIV aremore likely to have been more recentlyinfected compared with adults. Consequently,statistics on variation of HIV prevalenceamong youth are critical in understanding thepatterns of recent HIV infections.Table 14.11 presents HIV prevalenceamong youth by several demographic andsocioeconomic characteristics. Overall, 14Wealth quintileLowest (20.3) 32 19.8 529Second (23.1) 39 19.6 568Middle (17.0) 47 17.0 738Fourth 37.4 76 19.6 775Highest 13.3 112 21.3 847Total 15-49 21.8 306 19.5 3,457Note: Table is based on de facto household members who wereinterviewed and tested. Figures in parentheses are based on 25-49unweighted cases.1HIV positive refers only to individuals infected with HIV-1.percent of youth are infected with HIV. Prevalence of HIV is nearly four times higher among youngwomen than among young men (23 percent compared with 6 percent).HIV rates are higher among married or cohabiting youth than among unmarried youth. Asexpected, young pregnant women have a higher infection rate than young non-pregnant women (35percent compared with 22 percent). HIV prevalence among youth living in urban areas is slightly higherthan that of rural areas (18 percent compared with 13 percent). Youth in the Hhohho region have thehighest HIV prevalence compared with those from other regions.The prevalence of HIV among the small numbers of youth with no education is more than fivetimes higher than that of youth with more than secondary education (32 percent compared with 6percent). Among young women with no education, one in two is infected, while 13 percent of young menwith no education are infected.HIV Prevalence and Associated Factors | 235