The Effect of School Attendance and School Dropout on Incident HIV and HSV-2 among Young Women in Rural South Africa Enrolled in HPTN 068

Citation

Stoner, Marie C. D.; Pettifor, Audrey E.; Edwards, Jessie K.; Aiello, Allison E.; Halpern, Carolyn Tucker; Julien, Aimee; Selin, Amanda M.; Twine, Rhian; Hughes, James P.; & Wang, Jing, et al. (2017). The Effect of School Attendance and School Dropout on Incident HIV and HSV-2 among Young Women in Rural South Africa Enrolled in HPTN 068. AIDS, 31(15), 2127-2134. PMCID: PMC5599334

Abstract

OBJECTIVE: To estimate the association between school attendance, school dropout, and risk of incident HIV and HSV-2 infection among young women.
DESIGN: We used longitudinal data from a randomized controlled trial in rural Mpumalanga province, South Africa, to assess the association between school days attended, school dropout and incident HIV and HSV-2 in young women aged 13-23 years.
METHODS: We examined inverse probability of exposure weighted survival curves and used them to calculate 1.5, 2.5 and 3.5-year risk differences and risk ratios for the effect of school attendance on incident HIV and HSV-2. A marginal structural Cox model was used to estimate hazard ratios for the effect of school attendance and school dropout on incident infection.
RESULTS: Risk of infection increased over time as young women aged, and was higher in young women with low school attendance (<80% school days) compared to high (>/=80% school days). Young women with low attendance were more likely to acquire HIV (HR: 2.97; 95% CI: 1.62, 5.45) and HSV-2 (HR: 2.47; 95% CI: 1.46,4.17) over the follow up period than young women with high attendance. Similarly, young women who dropped out of school had a higher weighted hazard of both HIV (HR 3.25 95% CI: 1.67,6.32) and HSV-2 (HR 2.70; 95% CI 1.59,4.59).
CONCLUSION: Young women who attend more school days and stay in school have a lower risk of incident HIV and HSV-2 infection. Interventions to increase frequency of school attendance and prevent dropout should be promoted to reduce risk of infection.

URL

http://dx.doi.org/10.1097/qad.0000000000001584

Reference Type

Journal Article

Year Published

2017

Journal Title

AIDS

Author(s)

Stoner, Marie C. D.
Pettifor, Audrey E.
Edwards, Jessie K.
Aiello, Allison E.
Halpern, Carolyn Tucker
Julien, Aimee
Selin, Amanda M.
Twine, Rhian
Hughes, James P.
Wang, Jing
Agyei, Yaw
Gómez-Olivé, F. Xavier
Wagner, Ryan G.
MacPhail, Catherine Lorne
Kahn, Kathleen

PMCID

PMC5599334

ORCiD

Pettifor - 0000-0002-3387-0817
Halpern - 0000-0003-4278-5646
Aiello - 0000-0001-7029-2537
Stoner - 0000-0002-7189-8669
Edwards, J -0000-0002-1741-335X