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Publication: Multilevel measures of education and pathways to incident herpes simplex virus Type 2 in adolescent girls and young women in South Africa
Stoner, M.C.D Neilands, T.B Kahn, K Hughes, J.P Gómez-Olivé, F.X Twine, R Tollman, S Laeyendecker, O MacPhail, C Ahern, J
Stoner, M.C.D
Neilands, T.B
Kahn, K
Hughes, J.P
Gómez-Olivé, F.X
Twine, R
Tollman, S
Laeyendecker, O
MacPhail, C
Ahern, J
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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.
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Date
2019-12
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Elsevier
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Keywords
Adolescent girls and young women,Education,HSV-2,Mediation,Sexual behaviors,Multilevel,HIV prevention
Citation
Stoner MCD, Neilands TB, Kahn K, Hughes JP, Gómez-Olivé FX, Twine R, Tollman S, Laeyendecker O, MacPhail C, Ahern J, Lippman SA, Pettifor A. Multilevel Measures of Education and Pathways to Incident Herpes Simplex Virus Type 2 in Adolescent Girls and Young Women in South Africa. J Adolesc Health. 2019 Dec;65(6):723-729. doi: 10.1016/j.jadohealth.2019.06.008.