Format

Send to

Choose Destination
J Adolesc Health. 2018 Jan;62(1):44-51. doi: 10.1016/j.jadohealth.2017.07.015. Epub 2017 Nov 6.

School Support as Structural HIV Prevention for Adolescent Orphans in Western Kenya.

Author information

1
The Pacific Institute for Research and Evaluation, Chapel Hill, North Carolina. Electronic address: cho@pire.org.
2
School of Nursing, Moi University, Eldoret, Kenya.
3
The Pacific Institute for Research and Evaluation, Chapel Hill, North Carolina.
4
Department of Medicine, Microbiology & Immunology and Allied Health Sciences, University of North Carolina, Chapel Hill, North Carolina.
5
Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.

Abstract

PURPOSE:

Using a clustered randomized controlled trial design, we evaluated whether support to keep Kenyan orphaned adolescents in school reduces the risk of HIV infection.

METHODS:

Participants included 835 orphaned boys and girls in grades 7 and 8 (mean age at the baseline = 15 years) in western Kenya. Primary schools (N = 26) were randomized to the study condition. Intervention participants received school uniforms, payment of tuition when they transitioned into high school, and nurse visits to monitor school absenteeism and provide assistance to stay in school. Annual surveys were conducted from 2011 through 2014, and HIV and herpes simplex virus 2 (HSV-2) biomarker data were collected at the baseline and the end line. Data were analyzed using survey logistic regression or generalized estimating equations controlling for age, gender, and socioeconomic status.

RESULTS:

Intervention and control groups were equivalent at the baseline and did not differ on new HIV or HSV-2 incidence at the end line. The school support intervention increased school retention but had few HIV-related effects, except increased circumcision among male participants and reduced likelihood of transactional sex.

CONCLUSIONS:

Despite a strong study design, we found no relative reduction in HIV or HSV-2 infection after 3 years of intervention implementation. New incidence of HIV was lower than expected in this region among youth whose average age at end line was 18 years (range = 14-23). Although support for secondary school promises many benefits for vulnerable youth, our study adds to the growing body of research showing weak evidence for its effectiveness as an HIV prevention.

KEYWORDS:

HIV; Kenya; Orphans; School support

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center