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 - 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
SN - 1054-139X
VL - 65
SP - 723
EP - 729
JO - Journal of Adolescent Health
JF - Journal of Adolescent Health
IS - 6
ER -