Multilevel Measures of Education and Pathways to Incident Herpes Simplex Virus Type 2 in Adolescent Girls and Young Women in South Africa

Marie C.D. Stoner, Torsten B. Neilands, Kathleen Kahn, James P. Hughes, F. Xavier Gómez-Olivé, Rhian Twine, Stephen Tollman, Oliver Laeyendecker, Catherine MacPhail, Jennifer Ahern, Sheri A. Lippman, Audrey Pettifor

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)723-729
Number of pages7
JournalJournal of Adolescent Health
Volume65
Issue number6
DOIs
StatePublished - Dec 2019
Externally publishedYes

Keywords

  • Adolescent girls and young women
  • Education
  • HSV-2
  • Mediation
  • Multilevel
  • Sexual behaviors

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

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