Determining the relationship between perceptions of HIV susceptibility and HIV status of women who have sex with women

Abstract

Background: Adolescent girls and young women (AGYW) who have sex with women (WSW) are at potential risk for HIV, contradicting the common belief that WSW have low HIV susceptibility, a misperception persists despite evidence to refute it. Objective: This study examined the relationship between perceived HIV susceptibility and actual HIV status among South African AGYW WSW, focusing on those reporting at least one same-sex sexual experience, using data from the DREAMS Evaluation survey. Methods/Design: An archival study employing the Expanded Health Beliefs Model (EHBM) analysed secondary de-identified data from the DREAMS Evaluation Survey with a multistage stratified cluster sampling design. The sample comprised 18,296 AGYW aged 12-24 across four districts in South Africa, including 1,362 identified as WSW. ANOVA was conducted using SPSS 28 to explore the relationship between perceived HIV susceptibility and actual HIV status. Results: WSW's perceived HIV susceptibility was low (38.5%) to very low (25%), while HIV prevalence in this sample/group was 15.9%. No significant relationship was found between perceived HIV susceptibility and actual HIV status (p = 0.126). Conclusions: WSW do not perceive themselves as being susceptible to contracting HIV despite the high prevalence of the virus in this group. Public health interventions should focus on raising awareness about risk factors, such as low use of barrier protection, substance use, and other behaviours highlighted in the literature, to better inform and protect this population.