The Influence of School Attendance on Partner Selection and Sexually Transmitted Infections Among Young South African Women

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  • March 22, 2019
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  • Stoner, Marie
    • Affiliation: Gillings School of Global Public Health, Department of Epidemiology
Abstract
  • Increased level of education has been associated with a reduced risk of HIV and Herpes simplex virus type 2 (HSV-2) among men and women who have completed their education. However, few studies have directly examined school attendance and dropout among adolescent girls of school age despite the extremely high prevalence in this population. Those that have, have been cross-sectional in design and have not investigated the causal pathways through which attending school may reduce risk of HIV and HSV-2. Our study uses longitudinal data from a randomized trial of young South African women aged 13 -20 years. In aim one, we estimated the association between school attendance/dropout and partner age difference and number of sexual partners. We found that young women who attended more school and did not drop out were less likely to have an older partner and had fewer partners. In aim two, we estimated the association between school attendance and dropout and incident HIV and HSV-2 infection. Young women who attended more school and stayed in school were less likely to be infected with HIV and HSV-2 than those who attended less school or dropped out. In aim three, we explored if partner age difference or partner number mediated the relationships between school attendance and incident HIV and HSV-2 infection. When all young women did not have older partners, had 0 partners and 1 partner, the controlled direct effect of school attendance on HIV and HSV-2 was closer to the null than the total effect. Partner age difference and partner number both mediated the relationships between school attendance and incident HIV and HSV-2 infection. Interventions to increase frequency of school attendance and prevent dropout should be promoted to reduce risk of HIV and HSV-2 among young women. Additionally, school attendance reduces exposure to infection as a result of changes in partner age difference and number of sexual partners. Interventions to prevent infections in young women should focus on creating environments that occupy time and provide a safe space where young women can associate with their peers.
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  • In Copyright
Advisor
  • Pettifor, Audrey
  • Miller, William
  • Edwards, Jessie
  • Halpern, Carolyn
  • Aiello, Allison
Degree
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill
Graduation year
  • 2017
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