Assessing the feasibility of a life history calendar to measure HIV risk and health in older South Africans

Autoři: Enid Schatz aff001;  Lucia Knight aff003;  Robert F. Belli aff004;  Sanyu A. Mojola aff005
Působiště autorů: Department of Public Health, University of Missouri, Columbia, Missouri, United States of America aff001;  MRC/Wits Rural Health and Health Transitions Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa aff002;  School of Public Health, University of the Western Cape, Belville, South Africa aff003;  Department of Psychology, University of Nebraska, Lincoln, Nebraska, United States of America aff004;  Department of Sociology, Princeton University, Princeton, New Jersey, United States of America aff005;  Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, New Jersey, United States of America aff006;  Office of Population Research, Princeton University, Princeton, New Jersey, United States of America aff007
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article


Life history calendars capture patterns of behavior over time, uncovering transitions and trajectories. Despite the growing numbers of older persons living with HIV in southern Africa, little is known about how HIV testing and risk unfold in this population. Operationalizing a life course approach with the use of an innovative Testing and Risk History Calendar [TRHC], we collected pilot data on older South Africans’ risk and HIV testing. We found older persons were able to provide (1) reference points to facilitate recall over a 10-year period, (2) specifics about HIV tests during that decade, and (3) details that contextualize the testing data, such as living arrangements, relationships, and health status. Interviewer debriefing sessions after each interview captured information on context and links across domains. On a larger scale, the TRHC has potential to reveal pathways between sexual behavior, HIV testing and risk perception, and health at older ages.

Klíčová slova:

Aging – Elderly – Epidemiology of aging – HIV – HIV diagnosis and management – HIV epidemiology – Interpersonal relationships – Memory recall


1. Belli RF, Stafford FP, Alwin DF. Calendar and Time Diary Methods in Life Course Research. SAGE Publications Inc; 2009. 361 p.

2. Nelson IA. From Quantitative to Qualitative: Adapting the Life History Calendar Method. Field Methods. 2010 Nov 1;22(4):413–28.

3. Caspi A, Moffitt T, Thornton A, Freedman D, Amell J, Harrington H, et al. The Life History Calendar: A Research and clinical assessment method for collecting retrospective event-history data. International Journal of Methods in Psychiatric Research. 1996 01;6(2):101–14.

4. Harris DA, Parisi D “Mimmo.” Adapting Life History Calendars for Qualitative Research on Welfare Transitions, Adapting Life History Calendars for Qualitative Research on Welfare Transitions. Field Methods. 2007 Feb 1;19(1):40–58.

5. Glasner T, van der Vaart W, Belli RF. Calendar Interviewing and the Use of Landmark Events—Implications for Cross-cultural Surveys. BMS Bulletin of Sociological Methodology/ Bulletin de Methodologie Sociologique. 2012 01;115(1):45–52.

6. van der Vaart W, Glasner T. Personal Landmarks as Recall Aids in Survey Interviews. Field Methods. 2011 Feb 1;23(1):37–56.

7. Luke N, Clark S, Zulu EM. The relationship history calendar: improving the scope and quality of data on youth sexual behavior. Demography. 2011 Aug;48(3):1151–76. doi: 10.1007/s13524-011-0051-2 21732169

8. Kabiru CW, Luke N, Izugbara CO, Zulu EM. The correlates of HIV testing and impacts on sexual behavior: evidence from a life history study of young people in Kisumu, Kenya. BMC Public Health. 2010 Jul 13;10:412. doi: 10.1186/1471-2458-10-412 20624323

9. Belli RF, Agrawal S, Bilgen I. Health status and disability comparisons between CATI calendar and conventional questionnaire instruments. Qual Quant. 2012 Apr 1;46(3):813–28.

10. Barber BK, McNeely C, Allen C, Belli RF. Adult functioning in the occupied Palestinian territory: a survey and event history calendar assessment. The Lancet. 2017 Aug 1;390:S22.

11. Porcellato L, Carmichael F, Hulme C. Using occupational history calendars to capture lengthy and complex working lives: a mixed method approach with older people. International Journal of Social Research Methodology. 2016 May 3;19(3):269–86.

12. Goldberg R. Family Instability and Early Initiation of Sexual Activity in Western Kenya. Demography. 2013 Apr;50(2):725. doi: 10.1007/s13524-012-0150-8 23055236

13. Axinn WG, Pearce LD, Ghimire D. Innovations in Life History Calendar Applications. Social Science Research. 1999 Sep;28(3):243–64.

14. Negin J, Bärnighausen T, Lundgren JD, Mills EJ. Aging with HIV in Africa: the challenges of living longer. AIDS. 2012 Jul;26:S1–5. 22713477

15. Negin J, Rozea A, Martiniuk AL. HIV behavioural interventions targeted towards older adults: a systematic review. BMC Public Health. 2014 May 26;14(1):507.

16. Mojola SA, Williams J, Angotti N, Gómez-Olivé FX. HIV after 40 in rural South Africa: A life course approach to HIV vulnerability among middle aged and older adults. Social Science & Medicine. 2015 Oct;143:204–12.

17. Negin J, Nemser B, Cumming R, Lelerai E, Ben Amor Y, Pronyk P. HIV attitudes, awareness and testing among older adults in Africa. AIDS Behav. 2012 Jan;16(1):63–8. doi: 10.1007/s10461-011-9994-y 21739287

18. Knight L, Schatz E, Mukumbang FC. “I attend at Vanguard and I attend here as well”: barriers to accessing healthcare services among older South Africans with HIV and non-communicable diseases. International Journal for Equity in Health. 2018 Sep 18;17(1):147. doi: 10.1186/s12939-018-0863-4 30227859

19. Kilburn K, Ranganathan M, Stoner MCD, Hughes JP, MacPhail C, Agyei Y, et al. Transactional sex and incident HIV infection in a cohort of young women from rural South Africa. AIDS. 2018 Jul 31;32(12):1669–77. doi: 10.1097/QAD.0000000000001866 29762176

20. Psaros C, Milford C, Smit JA, Greener L, Mosery N, Matthews LT, et al. HIV Prevention Among Young Women in South Africa: Understanding Multiple Layers of Risk. Arch Sex Behav. 2018 Oct 1;47(7):1969–82. doi: 10.1007/s10508-017-1056-8 29134422

21. Shisana O, Rehle T, Simbayi L, Zuma K, Jooste S, Zungu N, et al. South African National HIV Prevalence, Incidence and Behaviour Survey, 2012. Cape Town; 2014.

22. Gómez-Olivé FX, Angotti N, Houle B, Klipstein-Grobusch K, Kabudula C, Menken J, et al. Prevalence of HIV among those 15 and older in rural South Africa. AIDS Care. 2013;25(9):1122–8. doi: 10.1080/09540121.2012.750710 23311396

23. Human Sciences Research Council. South African National HIV Prevalence, Incidence, Behavior and Communication Survey, 2017 [Internet]. HSRC Presentation; 2018. Available from:

24. Gómez-Olivé FX, Houle B, Rosenberg M, Mojola SA, Clark S, Kabudula C, et al. HIV Incidence among Older Adults in a Rural South African Setting: 2010–2015. In Austin, TX; 2019.

25. Vermund SH, Fidler SJ, Ayles H, Beyers N, Hayes RJ. Can combination prevention strategies reduce HIV transmission in generalized epidemic settings in Africa? The HPTN 071 (PopART) study plan in South Africa and Zambia. J Acquir Immune Defic Syndr. 2013 Jul;63 Suppl 2:S221–227.

26. Johnson LF, Rehle TM, Jooste S, Bekker L-G. Rates of HIV testing and diagnosis in South Africa: successes and challenges. AIDS. 2015 Jul 17;29(11):1401–9. doi: 10.1097/QAD.0000000000000721 26091299

27. Kipp WE, Alibhai A, Saunders D, Konde-Lule J, Ruhunda A. Public knowledge and attitudes toward HIV/AIDS and antiretroviral therapy in Kabarole district, western Uganda. AIDS Care. 2009 Jan 1;21(1):118–24. doi: 10.1080/09540120802068761 19085228

28. Freeman E, Anglewicz P. HIV prevalence and sexual behaviour at older ages in rural Malawi. Int J STD AIDS. 2012 Jul 1;23(7):490–6. doi: 10.1258/ijsa.2011.011340 22844003

29. Freeman E, Coast E. Sex in older age in rural Malawi. Ageing & Society. 2014 Aug;34(07):1118–1141.

30. Houle B, Mojola SA, Angotti N, Schatz E, Gómez-Olivé FX, Clark SJ, et al. Sexual behavior and HIV risk across the life course in rural South Africa: trends and comparisons. AIDS Care. 2018;30(11):1435–43. doi: 10.1080/09540121.2018.1468008 29701073

31. Rosenberg MS, Gómez-Olivé FX, Rohr JK, Houle BC, Kabudula CW, Wagner RG, et al. Sexual Behaviors and HIV Status: A Population-Based Study Among Older Adults in Rural South Africa. J Acquir Immune Defic Syndr. 2017 Jan 1;74(1):e9–17. doi: 10.1097/QAI.0000000000001173 27926667

32. Angotti N, Houle B, Schatz E, Mojola SA. Classifying and contextualizing sexual practices across the life course: Implications in later life. In Denver, CO; 2018.

33. Mojola SA, Angotti N. ‘Sometimes it is not about men’: Gendered and generational discourses of caregiving HIV transmission in a rural South African setting. Global Public Health. 2019 Apr 23;0(0):1–13.

34. Angotti N, Mojola SA, Schatz E, Williams JR, Gomez-Olive FX. “Taking care” in the age of AIDS: older rural South Africans’ strategies for surviving the HIV epidemic. Cult Health Sex. 2018;20(3):262–75. doi: 10.1080/13691058.2017.1340670 28741983

35. Richards E, Zalwango F, Seeley J, Scholten F, Theobald S. Neglected older women and men: Exploring age and gender as structural drivers of HIV among people aged over 60 in Uganda. African Journal of AIDS Research. 2013 Jun 1;12(2):71–8. doi: 10.2989/16085906.2013.831361 25871376

36. Dunkle KL, Jewkes R. Effective HIV prevention requires gender-transformative work with men. Sexually Transmitted Infections. 2007 Jun 1;83(3):173–4. doi: 10.1136/sti.2007.024950 17569718

37. Harling G, Newell M-L, Tanser F, Bärnighausen T. Partner Age-Disparity and HIV Incidence Risk for Older Women in Rural South Africa. AIDS Behav. 2015 Feb 11;1–10.

38. Akullian A, Bershteyn A, Klein D, Vandormael A, Bärnighausen T, Tanser F. Sexual partnership age pairings and risk of HIV acquisition in rural South Africa. AIDS. 2017 Jul 31;31(12):1755–64. doi: 10.1097/QAD.0000000000001553 28590328

39. Reniers G. Marital strategies for regulating exposure to HIV. Demography. 2008 May;45(2):417–38. doi: 10.1353/dem.0.0002 18613488

40. Makusha T, Mabaso M, Richter L, Desmond C, Jooste S, Simbayi L. Trends in HIV testing and associated factors among men in South Africa: evidence from 2005, 2008 and 2012 national population-based household surveys. Public Health. 2017 Feb;143:1–7. doi: 10.1016/j.puhe.2016.10.017 28159020

41. Schatz E, Knight L. “I was referred from the other side”: Gender and HIV testing among older South Africans living with HIV. PLOS ONE. 2018 Apr 23;13(4):e0196158. doi: 10.1371/journal.pone.0196158 29684054

42. Schatz E, Houle B, Mojola SA, Angotti N, Williams J. How to “Live a Good Life”: Aging and HIV Testing in Rural South Africa. J Aging Health. 2019 Apr 1;31(4):709–32. doi: 10.1177/0898264317751945 29318924

43. Musheke M, Ntalasha H, Gari S, Mckenzie O, Bond V, Martin-Hilber A, et al. A systematic review of qualitative findings on factors enabling and deterring uptake of HIV testing in Sub-Saharan Africa. BMC Public Health. 2013 Mar 11;13(1):220.

44. Siu GE, Wight D, Seeley JA. Masculinity, social context and HIV testing: an ethnographic study of men in Busia district, rural eastern Uganda. BMC Public Health. 2014 Jan 13;14:33. doi: 10.1186/1471-2458-14-33 24417763

45. Belli RF, Smith LM, Andreski PM, Agrawal S. Methodological Comparisons Between CATI Event History Calendar and Standardized Conventional Questionnaire Instruments. Public Opin Q. 2007 Jan 1;71(4):603–22.

46. van der Vaart W., Glasner T.J., Belli R.F. Tailoring data collection methods to hard-to-examine populations: the use of life events as recall aids in survey research. International Journal of Social Sciences and Humanity Studies. 2014;6:116–28.

47. Nnko S, Boerma JT, Urassa M, Mwaluko G, Zaba B. Secretive females or swaggering males? An assessment of the quality of sexual partnership reporting in rural Tanzania. Soc Sci Med. 2004 Jul;59(2):299–310. doi: 10.1016/j.socscimed.2003.10.031 15110421

48. Negin J, Geddes L, Brennan-Ing M, Kuteesa M, Karpiak S, Seeley J. Sexual Behavior of Older Adults Living with HIV in Uganda. Arch Sex Behav. 2015 Sep 1;45(2):441–9. doi: 10.1007/s10508-015-0582-5 26324184

49. Mayosi BM, Flisher AJ, Lalloo UG, Sitas F, Tollman SM, Bradshaw D. The burden of non-communicable diseases in South Africa. The Lancet. 2009 Sep 12;374(9693):934–47.

50. Mayosi BM, Lawn JE, van Niekerk A, Bradshaw D, Abdool Karim SS, Coovadia HM. Health in South Africa: changes and challenges since 2009. The Lancet. 2012;380(9858):2029–43.

51. Glasner T, van der Vaart W. Applications of calendar instruments in social surveys: a review. Qual Quant. 2009 May 1;43(3):333–49. doi: 10.1007/s11135-007-9129-8 20046840

52. Oni T, Youngblood E, Boulle A, McGrath N, Wilkinson RJ, Levitt NS. Patterns of HIV, TB, and non-communicable disease multi-morbidity in peri-urban South Africa- a cross sectional study. BMC Infectious Diseases. 2015 Jan 17;15:20. doi: 10.1186/s12879-015-0750-1 25595711

53. Kabudula CW, Houle B, Collinson MA, Kahn K, Tollman S, Clark S. Assessing Changes in Household Socioeconomic Status in Rural South Africa, 2001–2013: A Distributional Analysis Using Household Asset Indicators. Social Indicators Research [Internet]. 2016 Jun 28 [cited 2017 Aug 24]; Available from:

54. Belli RF, Miller LD, Baghal TA, Soh L-K. Using Data Mining to Predict the Occurrence of Respondent Retrieval Strategies in Calendar Interviewing: The Quality of Retrospective Reports. Journal of Official Statistics. 2016 Sep 1;32(3):579–600.

55. Belli RF, Al Baghal T. Parallel Associations and the Structure of Autobiographical Knowledge. Journal of Applied Research in Memory and Cognition. 2016 Jun 1;5(2):150–7.

56. Belli RF, Bilgen I, Al Baghal T. Memory, Communication, and Data Quality in Calendar Interviews. Public Opin Q. 2013 Jan 1;77(S1):194–219.

57. Houle B, Angotti N, Clark SJ, Gómez-Olivé FX, Williams J, Menken J, et al. Let’s Talk About Sex, Maybe: Respondents, Interviewers and Sexual Behavior Reporting in Rural South Africa. Field Methods. 2015;28(2). doi: 10.1177/1525822X15595343 28190977

Článek vyšel v časopise


2020 Číslo 1
Nejčtenější tento týden