TY - JOUR
T1 - Multilevel Measures of Education and Pathways to Incident Herpes Simplex Virus Type 2 in Adolescent Girls and Young Women in South Africa
AU - Stoner, Marie C.D.
AU - Neilands, Torsten B.
AU - Kahn, Kathleen
AU - Hughes, James P.
AU - Gómez-Olivé, F. Xavier
AU - Twine, Rhian
AU - Tollman, Stephen
AU - Laeyendecker, Oliver
AU - MacPhail, Catherine
AU - Ahern, Jennifer
AU - Lippman, Sheri A.
AU - Pettifor, Audrey
N1 - Funding Information:
This study was funded by the National Institutes of Health (NIH; R01MH087118 and R01 MH110186) and by Award Numbers UM1 AI068619 (HPTN Leadership and Operations Center), UM1AI068617 (HPTN Statistical and Data Management Center), and UM1AI068613 (HPTN Laboratory Center) from the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute of Mental Health, and the National Institute on Drug Abuse of the National Institutes of Health (NIH). Additional support was provided by the Division of Intramural Research, NIAID, NIH. This work was also supported by the Carolina Population Center and its NIH grant (P2C HD050924). The MRC/Wits Rural Public Health and Health Transitions Research Unit and Agincourt Health and Socio-Demographic Surveillance System have been supported by the University of the Witwatersrand, the Medical Research Council, South Africa, and the Wellcome Trust, UK (058893/Z/99/A, 069683/Z/02/Z, 085477/Z/08/Z, 085477/B/08/Z).
Funding Information:
This study was funded by the National Institutes of Health (NIH; R01MH087118 and R01 MH110186 ) and by Award Numbers UM1 AI068619 (HPTN Leadership and Operations Center), UM1AI068617 (HPTN Statistical and Data Management Center), and UM1AI068613 (HPTN Laboratory Center) from the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute of Mental Health , and the National Institute on Drug Abuse of the National Institutes of Health (NIH). Additional support was provided by the Division of Intramural Research, NIAID , NIH. This work was also supported by the Carolina Population Center and its NIH grant ( P2C HD050924 ). The MRC/Wits Rural Public Health and Health Transitions Research Unit and Agincourt Health and Socio-Demographic Surveillance System have been supported by the University of the Witwatersrand , the Medical Research Council, South Africa , and the Wellcome Trust , UK ( 058893/Z/99/A , 069683/Z/02/Z , 085477/Z/08/Z , 085477/B/08/Z ).
Publisher Copyright:
© 2019 Society for Adolescent Health and Medicine
PY - 2019/12
Y1 - 2019/12
N2 - Purpose: Schooling is associated with a lower risk of Herpes simplex virus type 2 (HSV-2) in adolescent girls and young women, but there is little understanding of the pathways underlying this relationship. Methods: We used data from adolescent girls and young women in South Africa enrolled in the HIV Prevention Trials Network 068 study. We tested a structural equation model where individual household and community education measures were associated directly and indirectly with incident HSV-2 through HIV knowledge, future aspirations, age-disparate partnerships, sex in the last 12 months, and condomless sex. Results: Community, household, and individual measures of schooling were all associated with incident HSV-2 infection through mediated pathways that increased the likelihood of having sex. Low school attendance (<80% of school days) increased the likelihood of having sex through increased age-disparate partnerships and reduced future aspirations. Fewer community years of education increased the likelihood of having sex through increased age-disparate partnerships. Parental education level was indirectly associated with HSV-2 overall, although we could not identify the individual pathways that were responsible for this association. Conclusions: Community and individual schooling interventions may reduce the risk of HSV-2 infection by influencing the likelihood of having sex, partner age, and future aspirations.
AB - Purpose: Schooling is associated with a lower risk of Herpes simplex virus type 2 (HSV-2) in adolescent girls and young women, but there is little understanding of the pathways underlying this relationship. Methods: We used data from adolescent girls and young women in South Africa enrolled in the HIV Prevention Trials Network 068 study. We tested a structural equation model where individual household and community education measures were associated directly and indirectly with incident HSV-2 through HIV knowledge, future aspirations, age-disparate partnerships, sex in the last 12 months, and condomless sex. Results: Community, household, and individual measures of schooling were all associated with incident HSV-2 infection through mediated pathways that increased the likelihood of having sex. Low school attendance (<80% of school days) increased the likelihood of having sex through increased age-disparate partnerships and reduced future aspirations. Fewer community years of education increased the likelihood of having sex through increased age-disparate partnerships. Parental education level was indirectly associated with HSV-2 overall, although we could not identify the individual pathways that were responsible for this association. Conclusions: Community and individual schooling interventions may reduce the risk of HSV-2 infection by influencing the likelihood of having sex, partner age, and future aspirations.
KW - Adolescent girls and young women
KW - Education
KW - HSV-2
KW - Mediation
KW - Multilevel
KW - Sexual behaviors
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U2 - 10.1016/j.jadohealth.2019.06.008
DO - 10.1016/j.jadohealth.2019.06.008
M3 - Article
C2 - 31521513
AN - SCOPUS:85071984888
VL - 65
SP - 723
EP - 729
JO - Journal of Adolescent Health
JF - Journal of Adolescent Health
SN - 1054-139X
IS - 6
ER -