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Inkwari: An Emerging High-Risk Place Potentiating HIV Spread Among Young Adults in a Hyper-Endemic South African Setting

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Abstract

Young adults in South Africa are at the epicenter of the HIV epidemic. The prevalence of HIV among young people in the province of KwaZulu-Natal (KZN) is particularly high. This study characterizes inkwari (Zulu word for raves or weekend-long parties) in eThekwini District, KZN and explored how these place-based dynamics shape the risk environment for the young adult attendees. In 2011, 13 qualitative interviews were conducted with men and women between 18 and 30 years-old who reported unprotected sex with at least one casual partner in the prior 3 months and attended an inkwari in the same time period. Interviews were analyzed using qualitative content analysis. Nine key informant interviews helped to triangulate these data. Five women and eight men were interviewed and the mean age was 25 years (SD 3.24). Ten reported meeting a sexual partner at an inkwari. Inkwari were characterized as sexualized settings with limited adult supervision. Participants attended inkwari to socialize with peers, use drugs and alcohol, and meet sexual partners. Sexual and physical violence also occurred at inkwari. Given the convergence of social, sexual, and substance-using networks at inkwari, further inquiry is needed to determine how this place may potentiate HIV transmission risk in an endemic setting.

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Acknowledgments

This project was supported by a research grant from the Mark and Lisa Schwartz Foundation. Dr. Mimiaga, Ms. Closson, Dr. Safren, Dr. Taylor, Ms. Perez-Brumer, Dr. Matthews, Dr. Psaros, Dr. Grelotti, and Dr. Bangsberg receive salary support from the National Institutes of Health. Dr. Safren is supported by Grant 5K24MH094214. Dr. Bangsberg is supported by grant 10K24087227. Dr. Psaros is supported by grant 1K23MH096651. Drs. Mimiaga, Bangsberg, and Safren are also supported by the Harvard University Center for AIDS Research (CFAR; Walker) 5P30AI060354-09.

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Authors and Affiliations

  1. Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, 1 Bowdoin Square, 7th Floor, Boston, MA, 02114, USA

    Matthew J. Mimiaga, Steven A. Safren & Christina Psaros

  2. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

    Matthew J. Mimiaga, Amaya Perez-Brumer & David J. Grelotti

  3. The Fenway Institute, Fenway Health, Boston, MA, USA

    Matthew J. Mimiaga, Elizabeth F. Closson, Steven A. Safren, Scott W. Taylor & Amaya Perez-Brumer

  4. Maternal, Adolescent, and Child Health Division, Department of Obstetrics and Gynecology, University of the Witwatersrand, Durban, South Africa

    Zonke Mabude, Nzwakie Mosery & Jennifer A. Smit

  5. Center for Global Health and Division of Infectious Disease, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA

    Lynn T. Matthews & David R. Bangsberg

  6. Department of Behavioral and Social Sciences Program in Public Health, Brown University, Providence, RI, USA

    Abigail Harrison

  7. Ragon Institute of MGH, MIT, and Harvard, Boston, MA, USA

    David R. Bangsberg

  8. School of Pharmacy and Pharmacology, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa

    Jennifer A. Smit

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  1. Matthew J. Mimiaga
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  2. Elizabeth F. Closson
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  4. Zonke Mabude
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  8. Lynn T. Matthews
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  9. Christina Psaros
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  10. Abigail Harrison
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  11. David J. Grelotti
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  12. David R. Bangsberg
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  13. Jennifer A. Smit
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Correspondence to Matthew J. Mimiaga.

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Mimiaga, M.J., Closson, E.F., Safren, S.A. et al. Inkwari: An Emerging High-Risk Place Potentiating HIV Spread Among Young Adults in a Hyper-Endemic South African Setting. Arch Sex Behav 44, 307–315 (2015). https://doi.org/10.1007/s10508-014-0330-2

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  • DOI: https://doi.org/10.1007/s10508-014-0330-2

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