1. Multilevel Measures of Education and Pathways to Incident Herpes Simplex Virus Type 2 in Adolescent Girls and Young Women in South Africa.
- Author
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Stoner MCD, Neilands TB, Kahn K, Hughes JP, Gómez-Olivé FX, Twine R, Tollman S, Laeyendecker O, MacPhail C, Ahern J, Lippman SA, and Pettifor A
- Subjects
- Adolescent, Adult, Age Factors, Female, Humans, Longitudinal Studies, Risk Factors, Schools, South Africa epidemiology, Young Adult, Educational Status, Health Education, Herpes Genitalis epidemiology, Herpes Genitalis prevention & control, Herpesvirus 2, Human isolation & purification, Sexual Partners
- 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., (Copyright © 2019 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)
- Published
- 2019
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