The association between being currently in school and HIV prevalence among young women in nine eastern and southern African countries.
<h4>Introduction</h4>Interventions to keep adolescent girls and young women in school, or support their return to school, are hypothesised to also reduce HIV risk. Such interventions are included in the DREAMS combination package of evidence-based interventions. Although there is evidenc...
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Public Library of Science (PLoS)
2018-01-01
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| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0198898&type=printable |
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| author | Paul Mee Elizabeth Fearon Syreen Hassan Bernadette Hensen Xeno Acharya Brian D Rice James R Hargreaves |
| author_facet | Paul Mee Elizabeth Fearon Syreen Hassan Bernadette Hensen Xeno Acharya Brian D Rice James R Hargreaves |
| author_sort | Paul Mee |
| collection | DOAJ |
| description | <h4>Introduction</h4>Interventions to keep adolescent girls and young women in school, or support their return to school, are hypothesised to also reduce HIV risk. Such interventions are included in the DREAMS combination package of evidence-based interventions. Although there is evidence of reduced risky sexual behaviours, the impact on HIV incidence is unclear. We used nationally representative surveys to investigate the association between being in school and HIV prevalence.<h4>Methods</h4>We analysed Demographic and Health Survey data from nine DREAMS countries in sub-Saharan Africa restricted to young women aged 15-19 (n = 20,429 in total). We used logistic regression to assess cross-sectional associations between being in school and HIV status and present odds ratios adjusted for age, socio-economic status, residence, marital status, educational attainment and birth history (aOR). We investigated whether associations seen differed across countries and by age.<h4>Results</h4>HIV prevalence (1.0%-9.8%), being currently in school (50.0%-72.6%) and the strength of association between the two, varied between countries. We found strong evidence that being currently in school was associated with a reduced odds of being HIV positive in Lesotho (aOR: 0.37; 95%CI: 0.17-0.79), Swaziland (aOR: 0.32; 95%CI: 0.17-0.59), and Uganda (aOR: 0.48: 95%CI: 0.29-0.80) and no statistically significant evidence for this in Kenya, Malawi, Mozambique, Tanzania, Zambia or Zimbabwe.<h4>Conclusions</h4>Although the relationship is not uniform across countries or over time, these data are supportive of the hypothesis that young women in school are at lower risk of being HIV positive than those who leave school in some sub-Saharan African settings. There is a possibility of reverse causality, with pre-existing HIV infection leading to school drop-out. Further investigation of the contextual factors behind this variation will be important in interpreting the results of HIV prevention interventions promoting retention in school. |
| format | Article |
| id | doaj-art-214dd1d5e2c04815b47df24233e5fd78 |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj-art-214dd1d5e2c04815b47df24233e5fd782025-08-20T03:12:50ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01136e019889810.1371/journal.pone.0198898The association between being currently in school and HIV prevalence among young women in nine eastern and southern African countries.Paul MeeElizabeth FearonSyreen HassanBernadette HensenXeno AcharyaBrian D RiceJames R Hargreaves<h4>Introduction</h4>Interventions to keep adolescent girls and young women in school, or support their return to school, are hypothesised to also reduce HIV risk. Such interventions are included in the DREAMS combination package of evidence-based interventions. Although there is evidence of reduced risky sexual behaviours, the impact on HIV incidence is unclear. We used nationally representative surveys to investigate the association between being in school and HIV prevalence.<h4>Methods</h4>We analysed Demographic and Health Survey data from nine DREAMS countries in sub-Saharan Africa restricted to young women aged 15-19 (n = 20,429 in total). We used logistic regression to assess cross-sectional associations between being in school and HIV status and present odds ratios adjusted for age, socio-economic status, residence, marital status, educational attainment and birth history (aOR). We investigated whether associations seen differed across countries and by age.<h4>Results</h4>HIV prevalence (1.0%-9.8%), being currently in school (50.0%-72.6%) and the strength of association between the two, varied between countries. We found strong evidence that being currently in school was associated with a reduced odds of being HIV positive in Lesotho (aOR: 0.37; 95%CI: 0.17-0.79), Swaziland (aOR: 0.32; 95%CI: 0.17-0.59), and Uganda (aOR: 0.48: 95%CI: 0.29-0.80) and no statistically significant evidence for this in Kenya, Malawi, Mozambique, Tanzania, Zambia or Zimbabwe.<h4>Conclusions</h4>Although the relationship is not uniform across countries or over time, these data are supportive of the hypothesis that young women in school are at lower risk of being HIV positive than those who leave school in some sub-Saharan African settings. There is a possibility of reverse causality, with pre-existing HIV infection leading to school drop-out. Further investigation of the contextual factors behind this variation will be important in interpreting the results of HIV prevention interventions promoting retention in school.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0198898&type=printable |
| spellingShingle | Paul Mee Elizabeth Fearon Syreen Hassan Bernadette Hensen Xeno Acharya Brian D Rice James R Hargreaves The association between being currently in school and HIV prevalence among young women in nine eastern and southern African countries. PLoS ONE |
| title | The association between being currently in school and HIV prevalence among young women in nine eastern and southern African countries. |
| title_full | The association between being currently in school and HIV prevalence among young women in nine eastern and southern African countries. |
| title_fullStr | The association between being currently in school and HIV prevalence among young women in nine eastern and southern African countries. |
| title_full_unstemmed | The association between being currently in school and HIV prevalence among young women in nine eastern and southern African countries. |
| title_short | The association between being currently in school and HIV prevalence among young women in nine eastern and southern African countries. |
| title_sort | association between being currently in school and hiv prevalence among young women in nine eastern and southern african countries |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0198898&type=printable |
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