The impact of school subsidies on HIV-related outcomes among adolescent female orphans
Journal of Adolescent Health
Pacific Institute for Research and Evaluation, 1516 E. Franklin Street, Chapel Hill, NC, United States; Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe; Faculty of Education, Africa University, Mutare, Zimbabwe; Pacific Institute for Research and Evaluation, Beltsville, MD, United States
Purpose We examine effects of school support as a structural HIV prevention intervention for adolescent female orphans in Zimbabwe after 5 years.Methods Three hundred twenty-eight orphan adolescent girls were followed in a clustered randomized controlled trial from 2007 to 2010. The experimental group received school fees, uniforms, and school supplies and were assigned a school-based "helper." In 2011-2012, the control group received delayed partial treatment of school fees only. At the final data point in 2012, survey, HIV, and Herpes Simplex Virus Type 2 (HSV-2) biomarker data were collected from approximately 88% of the sample. Bivariate and multivariate analyses were conducted on end point outcomes, controlling for age, religious affiliation, and baseline socioeconomic status.Results The two groups did not differ on HIV or HSV-2 biomarkers. The comprehensive 5-year intervention continued to reduce the likelihood of marriage, improve school retention, improve socioeconomic status (food security), and marginally maintain gains in quality of life, even after providing school fees to the control group.Conclusions Paying school fees and expenses resulted in significant improvements in life outcomes for orphan adolescent girls. Biological evidence of HIV infection prevention, however, was not observed. Our study adds to the growing body of research on school support as HIV prevention for girls in sub-Saharan Africa, but as yet, no clear picture of effectiveness has emerged. © 2015 Society for Adolescent Health and Medicine. All rights reserved.
biological marker; adolescent; adolescent disease; Article; child; controlled study; female; herpes simplex; Herpes simplex virus 2; human; Human immunodeficiency virus infection; infection prevention; major clinical study; orphanage; outcome assessment; primary school; quality of life; randomized controlled trial (topic); rural area; school; school subsidy; social status; Zimbabwe
R01HD55838, NIH, National Institutes of Health