Effects of neighbourhood-level educational attainment on HIV prevalence among young women in Zambia

Kayeyi, Nkomba; Sandøy, Ingvild Fossgard; Fýlkesnes, Knut

doi:10.1186/1471-2458-9-310

Cited by 30 publications

(34 citation statements)

References 34 publications

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“…Recent studies have called for emphasizing high school completion as a method of increasing our nation’s health (Freudenberg & Ruglis, 2007), and indeed, the US Department of Health & Human Services has proposed “Increase the educational attainment of adolescents and young adults” as a new objective for Healthy People 2020 (US Department of Health & Human Services, 2009). Findings from this study support the emphasis on high school completion as a means to reduce HIV risk among African-American women, corroborating findings from studies demonstrating the protective value of educational attainment among injection drug users and incarcerated women (Hasnain et al, 2007; Paasche-Orlow et al, 2005), and the protective value of school enrollment among adolescent females in the United States (Crosby et al, 2007; Manlove, 1998) and abroad (Hargreaves & Howe, 2010; Kayeyi et al, 2009; Pettifor et al, 2008). Furthermore, findings from this study suggest that graduating from college, over and above graduating from high school, may lead to a beneficial reduction in vulnerability to STIs/HIV among African-American young adult women.…”

Section: Discussionsupporting

confidence: 82%

“…Several studies have examined the association between educational attainment and HIV risk in developing countries (Birdthistle et al, 2009; Hargreaves et al, 2008; Hargreaves & Howe, 2010; Kayeyi, Sandoy, & Fylkesnes, 2009; Pettifor et al, 2008), and a few studies have examined the association between educational attainment and HIV risk among certain high-risk sub-populations in the United States, including injection drug users (Hasnain, Levy, Mensah, & Sinacore, 2007), and incarcerated women (Paasche-Orlow, Clarke, Hebert, Ray, & Stein, 2005). Together, these studies have provided mixed evidence for the effects of educational attainment on HIV risk.…”

Section: Introductionmentioning

confidence: 99%

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College Graduation Reduces Vulnerability to STIs/HIV among African-American Young Adult Women

Painter

Wingood

DiClemente

et al. 2012

Women's Health Issues

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African-American women are disproportionately affected by STIs including HIV. The Theory of Gender and Power (TGP) posits that economic exposures, including educational attainment, place women at increased risk for STIs/HIV. This study examined the association between educational attainment and vulnerability to STIs/HIV, as well as potential TGP-driven mediators of this association, among African-American women. Baseline data were assessed from an STI/HIV prevention intervention for African-American women (N=848) aged 18–29 recruited from three Kaiser Permanente Centers in Atlanta, GA. Data collection included 1) a survey of demographic, psychosocial, and behavioral measures and 2) self-collected, laboratory-confirmed vaginal swabs for STIs (trichomoniasis, chlamydia, gonorrhea, and human papillomavirus). Multiple regression analyses and multivariate mediation analyses were used to examine the association between educational attainment with a laboratory-confirmed STI and potential TGP mediators. Controlling for age and receipt of public assistance, the odds of an STI diagnosis were 73% lower among participants with a college degree or greater compared to participants who had not completed high school. There were also significant associations between educational attainment and multiple TGP mediators from the Sexual Division of Power and the Structure of Cathexis. TGP constructs did not mediate the association between educational attainment and laboratory-confirmed STI. The current study suggests that graduating from college may lead to a beneficial reduction in vulnerability to STIs/HIV among African-American women. Findings from this study support expanding structural level interventions, emphasizing both high-school and college graduation, as a means of reducing vulnerability to STIs/HIV among African-American women.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

College Graduation Reduces Vulnerability to STIs/HIV among African-American Young Adult Women

Painter

Wingood

DiClemente

et al. 2012

Women's Health Issues

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“…A growing number of studies in the past decade have addressed the issue of HIV/AIDS-related stigma [18–20]. …”

Section: Introductionmentioning

confidence: 99%

A generation at risk: a cross-sectional study on HIV/AIDS knowledge, exposure to mass media, and stigmatizing behaviors among young women aged 15–24 years in Ghana

Asamoah

Agardh

2017

Global Health Action

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HIV/AIDS stigmatizing behaviors are a huge barrier to early detection and treatment of individuals with the AIDS virus. HIV/AIDS stigma and related consequences are debilitating, especially for vulnerable populations. This study sought to assess whether young women’s HIV/AIDS knowledge levels and exposure to mass media (television and radio) have an influence on their stigmatizing behaviors and role as agents of stigma towards individuals living with HIV and AIDS. The data used for this study originated from the Ghana Multiple Indicator Cluster Survey 2011. Binary and multiple (stepwise) logistic regression analyses were used to examine the associations between HIV/AIDS knowledge, frequency of exposure to mass media, and HIV/AIDS stigmatizing behaviors among young women aged 15–24 years in Ghana. Of the 3573 young women, 80% of 15–19-year-olds and 76% of 20–24-year-olds had at least one stigmatizing behavior towards persons living with HIV/AIDS (PLHA). Young women with increased knowledge regarding HIV/AIDS and frequent exposure to mass media (television and radio) had lesser tendency to stigmatize or act as agents of stigma towards PLHA (proportion with at least one stigmatizing behavior per subgroup – HIV/AIDS knowledge: those with highest knowledge score 579 [70.1%], those with lowest knowledge score 28 [90.3%]; mass media: those with daily exposure 562 [73.4%], those not exposed at all 249 [89.2%]). There was a graded negative ‘exposure–response’ association between the ranked variables: HIV/AIDS knowledge, mass media, and HIV/AIDS stigmatizing behaviors. The significant inverse association between HIV/AIDS knowledge, frequency of exposure to mass media, and HIV/AIDS stigmatizing behaviors persisted even after adjusting for all other covariates in the multiple logistic regression models. It is extremely important to increase HIV/AIDS-related knowledge and reduce stigma among young women in Ghana through targeted HIV/AIDS factual knowledge transfer. The use of mass media for communication of issues regarding HIV/AIDS, its mode of transmission, and associated stigma should be emphasized among women in Ghana.

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“…For this reason, HIV testing services need to be available and accessible to all people to enable easy utilisation. 6 To ensure targets are met, Zimbabwe needs to improve HIV testing coverage, but scaling up HIV testing coverage; currently estimated at 56% can be daunting, given that HIV testing is voluntary. The success of the HIV self-testing programme will require a better understanding of the factors that influence people's HIV testing behaviour, which this study seeks to achieve.…”

Section: Introductionmentioning

confidence: 99%

A Multilevel Analysis of the Determinants of HIV Testing in Zimbabwe: Evidence from the Demographic and Health Surveys

Gazimbi

Magadi²

2017

HIV/AIDS Res Treat Open J

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Introduction: Zimbabwe is still burdened with HIV epidemic and the government has an ambitious aim in the post-2015 era to end the AIDS epidemic by 2030. To achieve this, the government has set up the 90-90-90 strategic milestones to be achieved by 2020. It is a daunting task to increase HIV testing uptake from the current estimate of 56% to 90% to meet these targets. The current government's initiative requires an understanding of determinants of HIV testing. Objectives: The specific objectives of this study are to: (i) identify the individual and communitylevel determinants of HIV testing, focussing on predisposing, enabling and perceived need factors (PREP); and (ii) establish gender differences. Most PREP factors associated with HIV testing are largely consistent with patterns in Southern Africa (e.g., higher uptake by women and those who are wealthier), but unique patterns have also emerged. In particular, results reveal important gender differences: rural residence is associated with lower uptake of HIV testing for women (OR=0.74) but higher for men (OR=1.16); community wealth is a more important factor in enabling HIV testing than household wealth for women, but the converse is true for men; and individual-level, rather than community-level stigma is important for women, while for men, it is community-level stigma that is important. Conclusion: Observed gender disparities in determinants of HIV testing calls for gender specific response. Couple-oriented HIV counselling and testing services where men accompany their spouse to HIV screening during pregnancy may help increase HIV testing uptake for males and reduce gender disparities.

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Effects of neighbourhood-level educational attainment on HIV prevalence among young women in Zambia

Cited by 30 publications

References 34 publications

College Graduation Reduces Vulnerability to STIs/HIV among African-American Young Adult Women

College Graduation Reduces Vulnerability to STIs/HIV among African-American Young Adult Women

A generation at risk: a cross-sectional study on HIV/AIDS knowledge, exposure to mass media, and stigmatizing behaviors among young women aged 15–24 years in Ghana

A Multilevel Analysis of the Determinants of HIV Testing in Zimbabwe: Evidence from the Demographic and Health Surveys

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