Socioeconomic determinants of risky sexual behaviors and HIV seropositivity among university students in South Africa: A case control analysis

Socioeconomic determinants of risky sexual behaviors in sub‐Saharan Africa are well known. The socioeconomic determinants of the sexual behaviors of university students, however, remain unclear. This case control study aimed to investigate the socioeconomic determinants of risky sexual behavior and HIV seropositivity among university students in KwaZulu‐Natal (KZN), South Africa. Participants (N = 500; 375 HIV uninfected and 125 HIV infected) from four public higher educational institutions in KZN were recruited, using a non‐randomized strategy. Socioeconomic status was assessed by food insecurity, access to the government loan scheme, and sharing of the bursary/loan with family. The findings of this study suggest that students reporting food insecurity were 1.87 times more likely to have multiple sexual partners; 3.18 times more likely to engage in transactional sex for money; and presented a fivefold higher risk of engaging in transactional sex for basic needs other than money. Accessing the government financing for education and sharing of the bursary/loan with family was also significantly associated with an increased risk of having an HIV seropositive status. A significant association between socioeconomic measures, risky sexual behavior, and HIV seropositivity is demonstrated in this study. Moreover, the socioeconomic risks and drivers when determining and/or developing HIV prevention interventions, including preexposure prophylaxis use, should be considered by healthcare providers based at campus health clinics.