Multilevel measures of education and pathways to incident HSV-2 in adolescent girls and young women in South Africa (HPTN 068)

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dc.contributor.authorMarie C.D. Stoner, PhD
dc.contributor.authorTorsten B. Neilands, PhD
dc.contributor.authorKathleen Kahn, PhD
dc.contributor.authorJames P. Hughes, PhD
dc.contributor.authorF. Xavier Gómez-Olivé, PhD
dc.contributor.authorRhian Twine, MPH
dc.contributor.authorStephen Tollman
dc.contributor.authorOliver Laeyendecker, PhD
dc.contributor.authorCatherine MacPhail, PhD
dc.contributor.authorJennifer Ahern, PhD
dc.contributor.authorSheri A. Lippman
dc.contributor.authorAudrey Pettifor, PhD
dc.date.accessioned2023-09-12T10:12:50Z
dc.date.available2023-09-12T10:12:50Z
dc.date.issued2019-12
dc.departmentSA-MRC/Wits Agincourt UnitE
dc.description.abstractPurpose: 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. Keywords: Adolescent girls and young women; Education; HSV-2; Mediation; Multilevel; Sexual behaviors.
dc.description.librarianPM2023
dc.identifier.urihttp://hdl.handle.net/10539/35874
dc.language.isoen
dc.schoolPublic HealthE
dc.titleMultilevel measures of education and pathways to incident HSV-2 in adolescent girls and young women in South Africa (HPTN 068)
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