Table 1. Demographic characteristics of HIV negative adults aged 15–54 in Manicaland, prior to and during the Covid-19 pandemic.
| A) Males | B) Females | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Cross-sectional analysis | Cohort analysis | Cross-sectional analysis | Cohort analysis | |||||||||||||
| Pre-Covid | During Covid | Pre-Covid | During Covid | Pre-Covid | During Covid | Pre-Covid | During Covid | |||||||||
| % (95%CI)* | % (95%CI) | AOR† (95%CI) | p | % (95%CI) | % (95%CI) | AOR† (95%CI) | p | % (95%CI)* | % (95%CI) | AOR† (95%CI) | p | % (95%CI) | % (95%CI) | AOR† (95%CI) | p | |
| 15-54yrs | N = 3181 | N = 2773 | N = 1171 | N = 1171 | N = 4135 | N = 3541 | N = 1997 | N = 1997 | ||||||||
| Age Group | ||||||||||||||||
| 15–19 | 26.4 (25.0–27.9) | 25.8 (24.2–27.5) | 25.8 (23.4–28.4) | 17.8(15.7–20.1) | 21.5(20.4–22.7) | 20.7 (19.4–22.1) | 15.7 (14.2–17.4) | 10.6 (9.34–12.0) | ||||||||
| 20–24 | 17.6 (16.4–18.9) | 16.1 (14.8–17.5) | 12.7 (10.9–14.8) | 15.5(13.6–17.7) | 18.8(17.7–19.9) | 15.9 (14.7–17.1) | 14.6 (13.1–16.2) | 12.8 (11.4–14.3) | ||||||||
| 25–29 | 11.7 (10.7–12.8) | 12.3 (11.1–13.5) | 9.74 (8.16–11.6) | 10.8 (9.19–12.8) | 13.8(12.7–15.0) | 14.5(13.4–15.7) | 13.8(12.3–15.4) | 15.2(13.7–16.8) | ||||||||
| 30–34 | 12.3 (11.1–13.7) | 10.4 (9.34–11.6) | 11.5 (9.82–13.5) | 10.6 (8.95–12.5) | 13.7(12.6–14.9) | 12.5(11.4–13.6) | 15.7(14.1–17.3) | 13.9 (12.5–15.5) | ||||||||
| 35–44 | 20.2 (18.7–21.8) | 21.8 (20.3–23.4) | 24.4 (22.0–27.0) | 25.7(23.3–28.3) | 20.2(18.9–21.5) | 22.7 (21.3–24.1) | 25.2 (23.3–27.1) | 27.6 (25.7–29.6) | ||||||||
| 45–54 | 11.8 (10.6–13.1) | 13.6 (12.3–14.9) | 15.8 (13.8–18.0) | 16.5(14.5–18.7) | 12.0(10.9–13.1) | 13.7 (12.6–14.9) | 15.0 (13.5–16.7) | 16.4 (14.9–18.1) | ||||||||
| 55+ | 3.07(2.22–4.23) | 3.51 (2.78–4.41) | ||||||||||||||
| Site Type ‡ | ||||||||||||||||
| Urban | 14.5 (13.3–15.7) | 20.6 (19.1–22.1) | 1.53 (1.33–1.75) | <0.001 | 14.8 (12.9–16.9) | 14.8(12.9–16.9) | 0.99(0.78–1.25) | 0.93 | 18.7(17.6–20.0) | 19.5 (18.2–20.8) | 1.06 (0.95–1.19) | 0.32 | 15.6 (14.0–17.2) | 15.6 (14.0–17.2) | 1.04 (0.87–1.23) | 0.69 |
| Periurban | 23.1 (21.6–24.6) | 27.8 (26.1–29.5) | 1.28 (1.14–1.44) | <0.001 | 25.7 (23.3–28.3) | 25.7(23.3–28.3) | 1.03(0.85–1.24) | 0.75 | 28.1(26.7–29.5) | 30.3 (28.8–31.9) | 1.12 (1.01–1.24) | 0.03 | 30.2 (28.3–32.3) | 30.2 (28.3–32.3) | 1.01 (0.88–1.16) | 0.84 |
| Estates | 32.6 (30.9–34.3) | 24.8 (23.3–26.5) | 0.68 (0.61–0.77) | <0.001 | 30.3 (27.7–33.0) | 30.3(27.7–33.0) | 1.00(0.83–1.20) | 0.99 | 21.9(20.7–23.3) | 21.2 (19.9–22.6) | 0.95 (0.85–1.06) | 0.34 | 21.1 (19.4–23.0) | 21.1 (19.4–23.0) | 0.98 (0.84–1.14) | 0.78 |
| Rural | 29.9(28.3–31.5) | 26.8 (25.2–28.5) | 0.86 (0.76–0.96) | 0.01 | 29.2 (26.7–31.9) | 29.2(26.7–31.9) | 0.98(0.82–1.17) | 0.81 | 31.2(29.8–32.7) | 29.0 (27.5–30.5) | 0.89 (0.81–0.99) | 0.03 | 33.0 (31.0–35.1) | 33.0 (31.0–35.1) | 0.98 (0.86–1.12) | 0.79 |
| Marital Status | ||||||||||||||||
| Never married | 43.7 (42.0–45.5) | 43.3 (41.5–45.2) | 1.08 (0.91–1.29) | 0.36 | 38.4 (35.7–41.3) | 33.7(31.1–36.5) | 1.13(0.83–1.55) | 0.44 | 23.8 (22.6–25.1) | 23.9 (22.5–25.3) | 1.17 (1.02–1.35) | 0.03 | 17.7 (16.1–19.4) | 15.2 (13.7–16.9) | 1.34 (1.05–1.71) | 0.02 |
| Married/cohabiting | 52.5 (50.8–54.3) | 53.4 (51.5–55.3) | 0.97 (0.83–1.14) | 0.69 | 59.1 (56.2–61.9) | 62.9(60.0–65.6) | 0.83(0.63–1.10) | 0.20 | 64.8 (63.3–66.2) | 63.0 (61.4–64.6) | 0.85 (0.76–0.95) | 0.003 | 71.6 (69.6–73.5) | 73.1 (71.1–75.0) | 0.92 (0.78–1.08) | 0.30 |
| Divorced/separated | 3.51 (2.88–4.28) | 2.92 (2.36–3.62) | 0.86 (0.63–1.17) | 0.34 | 2.22 (1.52–3.24) | 3.07(2.22–4.23) | 1.29(0.77–2.17) | 0.33 | 8.58 (7.73–9.52) | 9.86 (8.92–10.9) | 1.14 (0.97–1.33) | 0.12 | 7.66 (6.57–8.91) | 7.41 (6.34–8.65) | 0.88 (0.69–1.13) | 0.32 |
| Widowed | 0.23 (0.10–0.51) | 0.36 (0.19–0.67) | 1.35 (0.48–3.78) | 0.57 | 0.26 (0.08–0.79) | 0.34(0.13–0.91) | 1.30(0.29–5.85) | 0.73 | 2.80 (2.30–3.40) | 3.28 (2.74–3.92) | 1.10 (0.82–1.46) | 0.53 | 3.05 (2.38–3.91) | 4.26 (3.45–5.24) | 1.04 (0.72–1.51) | 0.83 |
| Household Wealth Index § | ||||||||||||||||
| Poorest | 9.81 (8.79–10.9) | 5.59 (4.80–6.51) | 0.55 (0.45–0.68) | <0.001 | 9.65 (8.08–11.5) | 7.34 (5.98–8.99) | 0.72 (0.53–0.99) | 0.04 | 8.97 (8.12–9.90) | 6.70 (5.92–7.57) | 0.74 (0.62–0.88) | 0.001 | 9.51 (8.30–10.9) | 8.17 (7.04–9.45) | 0.84 (0.67–1.06) | 0.15 |
| 2nd poorest | 46.5 (44.8–48.3) | 42.1 (40.3–44.0) | 0.98 (0.88–1.10) | 0.77 | 42.7 (39.9–45.6) | 42.5 (39.7–45.4) | 1.00 (0.84–1.19) | 0.99 | 40.3 (38.8–41.9) | 41.4 (39.8–43.1) | 1.11 (1.00–1.22) | 0.04 | 41.5 (39.4–43.7) | 42.9 (40.7–45.1) | 1.06 (0.93–1.22) | 0.38 |
| 3rd poorest | 22.3 (20.8–23.8) | 29.3 (27.7–31.1) | 1.41 (1.25–1.59) | <0.001 | 24.0 (21.6–26.5) | 28.4 (25.9–31.1) | 1.26 (1.04–1.52) | 0.02 | 24.0 (22.7–25.4) | 28.1 (26.7–29.6) | 1.22 (1.10–1.36) | <0.001 | 24.3 (22.5–26.2) | 26.2 (24.3–28.1) | 1.11 (0.96–1.28) | 0.17 |
| 4th poorest | 20.1 (18.8–21.6) | 22.2 (20.7–23.8) | 0.90 (0.78–1.03) | 0.12 | 22.1 (19.8–24.6) | 20.9 (18.7–23.3) | 0.91 (0.73–1.13) | 0.40 | 25.0 (23.7–26.3) | 22.7 (21.4–24.1) | 0.81 (0.72–0.91) | <0.001 | 23.3 (21.5–25.2) | 21.8 (20.0–23.7) | 0.89 (0.76–1.05) | 0.18 |
| Least poor | 1.25 (0.91–1.70) | 0.76 (0.49–1.16) | 0.52 (0.30–0.89) | 0.02 | 1.54 (0.97–2.43) | 0.77 (0.40–1.47) | 0.91 (0.73–1.13) | 0.40 | 1.70 (1.34–2.15) | 1.02 (0.73–1.41) | 0.58 (0.39–0.88) | 0.01 | 1.40 (0.97–2.02) | 1.00 (0.65–1.55) | 0.74 (0.41–1.32) | 0.31 |
| Employment | ||||||||||||||||
| Professional or managerial | 4.03 (3.35–4.85) | 6.31 (5.46–7.28) | 1.48 (1.15–1.91) | 0.00 | 4.95 (3.85–6.36) | 6.40 (5.14–7.96) | 1.20 (0.83–1.73) | 0.33 | 3.63 (3.06–4.30) | 4.69 (4.04–5.44) | 1.21 (0.95–1.54) | 0.12 | 3.61 (2.87–4.52) | 4.61 (3.77–5.62) | 1.20 (0.87–1.66) | 0.27 |
| Self-employed: small business | 1.17 (0.83–1.63) | 1.33 (0.97–1.84) | 0.96 (0.60–1.55) | 0.87 | 1.20 (0.71–2.01) | 1.28 (0.77–2.11) | 1.03 (0.49–2.15) | 0.95 | 0.46 (0.29–0.76) | 1.47 (1.12–1.92) | 3.36 (1.90–5.93) | <0.001 | 0.60 (0.34–1.06) | 1.60 (1.14–2.26) | 2.48 (1.26–4.88) | 0.01 |
| Skilled labour | 7.40 (6.48–8.43) | 14.3 (13.1–15.7) | 2.42 (2.01–2.92) | <0.001 | 8.28 (6.83–10.0) | 15.8 (13.8–18.0) | 1.96 (1.49–2.58) | <0.001 | 2.34 (1.90–2.89) | 4.52 (3.88–5.25) | 1.97 (1.50–2.58) | <0.001 | 2.40 (1.82–3.18) | 3.76 (3.00–4.69) | 1.47 (1.01–2.15) | 0.04 |
| Manual/unskilled labour | 18.8 (17.5–20.3) | 15.5 (14.2–16.9) | 0.99 (0.84–1.16) | 0.86 | 13.8 (12.0–15.9) | 17.6 (15.5–19.9) | 1.32 (1.03–1.69) | 0.03 | 4.42 (3.80–5.13) | 7.79 (6.96–8.72) | 1.90 (1.55–2.34) | <0.001 | 4.36 (3.54–5.35) | 8.21 (7.09–9.50) | 2.00 (1.51–2.65) | <0.001 |
| Informal employment | 15.0 (13.7–16.3) | 14.1 (12.8–15.4) | 0.81 (0.69–0.94) | 0.01 | 17.0 (14.9–19.3) | 16.0 (14.0–18.2) | 0.84 (0.67–1.06) | 0.14 | 13.7 (12.6–14.8) | 18.8 (17.6–20.1) | 1.41 (1.24–1.60) | <0.001 | 15.9 (14.4–17.6) | 23.6 (21.8–25.6) | 1.56 (1.33–1.84) | <0.001 |
| Student | 22.2 (20.8–23.6) | 19.8 (18.4–21.4) | 0.77 (0.64–0.92) | 0.004 | 24.2 (21.8–26.7) | 11.7 (10.0–13.7) | 0.32 (0.23–0.45) | <0.001 | 15.2 (14.3–16.3) | 15.3 (14.2–16.6) | 1.13 (0.96–1.32) | 0.15 | 12.7 (11.3–14.2) | 8.06 (6.95–9.34) | 0.78 (0.58–1.04) | 0.09 |
| Unemployed | 24.8 (23.3–26.4) | 28.6 (27.0–30.3) | 1.20 (1.06–1.35) | 0.004 | 23.7(21.3–26.2) | 31.3(28.7–34.0) | 1.44 (1.18–1.74) | <0.001 | 52.5 (51.0–54.1) | 47.4 (45.7–49.0) | 0.82 (0.75–0.90) | <0.001 | 52.8 (50.6–55.0) | 50.1 (47.9–52.3) | 0.84 (0.73–0.95) | 0.01 |
| Other: unspecified‖ | 6.61 (5.76–7.57) | 6.92 (5.60–8.52) | 7.64 (6.84–8.53) | 7.61 (6.53–8.86) | ||||||||||||
| Alcohol/Drugs | ||||||||||||||||
| Drank alcohol in the past year | 26.9 (25.3–28.5) | 21.7 (20.2–23.2) | 0.73 (0.64–0.84) | <0.001 | 27.3 (24.8–30.0) | 26.5 (24.0–29.1) | 0.86 (0.71–1.05) | 0.13 | 2.01 (1.62–2.50) | 2.40 (1.94–2.96) | 1.19 (0.87–1.62) | 0.27 | 2.10 (1.56–2.83) | 1.85 (1.35–2.55) | 0.84 (0.53–1.33) | 0.46 |
| Visited bar, beerhall or shebeen in past month | 31.0 (29.3–32.7) | 16.9 (15.6–18.4) | 0.44 (0.39–0.51) | <0.001 | 31.4 (28.8–34.1) | 21.4 (19.1–23.9) | 0.52 (0.43–0.63) | <0.001 | 0.62 (0.42–0.91) | 0.62 (0.41–0.94) | 0.97 (0.55–1.71) | 0.91 | 0.40 (0.20–0.80) | 0.60 (0.34–1.06) | 1.42 (0.57–3.55) | 0.45 |
| Using drugs for pleasure | 4.78 (4.08–5.61) | 2.92 (2.36–3.62) | 0.60 (0.45–0.79) | <0.001 | 3.76 (2.81–5.01) | 3.67 (2.73–4.92) | 0.90 (0.58–1.39) | 0.63 | 0.19 (0.10–0.39) | 0.34 (0.19–0.60) | 1.81 (0.73–4.48) | 0.20 | 0.05 (0.01–0.35) | 0.30 (0.13–0.67) | 6.50 (0.78–54.27) | 0.08 |
| 15-19yrs | N = 986 | N = 716 | N = 302 | N = 302 | N = 1112 | N = 734 | N = 314 | N = 314 | ||||||||
| Currently Enrolled in Education | 73.2 (70.4–75.9) | 64.0 (60.4–67.4) | 0.64 (0.50–0.82) | <0.001 | 84.4 (79.9–88.1) | 37.7 (32.4–43.4) | 0.33 (0.21–0.52) | <0.001 | 57.7 (54.8–60.6) | 57.1 (53.5–60.6) | 1.06 (0.84–1.33) | 0.64 | 69.4 (64.1–74.3) | 36.0 (30.8–41.5) | 0.90 (0.59–1.37) | 0.62 |
* In the cross-sectional analysis of the pre-covid survey, proportions are weighted to account for age bias in selection
† Odds ratios are adjusted for 5 year age group and site type. For variables limited to 15–19 year olds odds ratios are adjusted for site type and age in years.
‡ Note that no specific procedures were followed to identify individuals moving to different study site between the survey rounds
§Household wealth was estimated for each individual by assessing asset ownership within their household and attributing a score as described by Schur et al.19 Each asset variable was transformed into scores between 0 and 1. The values of each asset variable were then summed and divided by the total number of assets giving an overall score between 0 and 1. Equally spaced cut offs (0,0.2, 0.4, 0.6, 0.8) were used to categorise the overall wealth of a household into five groups.
‖ These individuals answered ’other’ for their category of employment but then did not specify in the follow up question so they could not be recoded to any of the other categories.