Birdthistle Isolde, Floyd Sian, Nyagadza Auxillia, Mudziwapasi Netsai, Gregson Simon, Glynn Judith R
London School of Hygiene & Tropical Medicine, London, United Kingdom.
Soc Sci Med. 2009 May;68(10):1810-8. doi: 10.1016/j.socscimed.2009.02.035. Epub 2009 Mar 19.
As the population of orphans grows in AIDS-affected settings, recent studies describe a heightened risk of HIV and sexual risk behaviours among adolescent orphans compared to their non-orphaned peers. This study explores the role of education in explaining the excess sexual risk previously documented among unmarried female orphans in urban Zimbabwe. School attendance and attainment were assessed by type of orphanhood, and for their association with markers of sexual risk (HIV and/or HSV-2 infection) among 743 participants drawn from a random sample of 15-19-year-old girls identified in a cross-sectional survey in Highfield, Harare, in 2004. Multivariable logistic regression was used to assess the role of educational status in explaining the higher prevalence of adverse sexual outcomes among unmarried orphans compared to non-orphans, adjusting for possible confounders. Double orphans had significantly lower educational attendance and attainment than non-orphans. Maternal orphans had higher odds of school drop-out, although this association disappeared when adjusted for recent mobility. Educational status was strongly associated with HIV/HSV-2 risk, but explained only a small part of double orphans' sexual risk and did not explain the HIV/HSV-2 risk of maternal and paternal orphans. High overall levels of secondary school participation and school fee assistance provided to vulnerable families may have reduced the schooling disparities between orphans and non-orphans in Highfield. However, further efforts are needed to rectify the schooling inequities that persist, while additional research is needed to identify other socio-economic and emotional factors driving orphans' sexual risk so that prevention and support programmes can meet the needs of this growing population.
在受艾滋病影响的地区,孤儿人口不断增加,最近的研究表明,与非孤儿同龄人相比,青少年孤儿感染艾滋病毒的风险更高,性行为风险行为也更多。本研究探讨教育在解释此前在津巴布韦城市未婚女性孤儿中记录的额外性风险方面所起的作用。通过孤儿类型评估入学率和学业成绩,并在2004年于哈拉雷高地进行的横断面调查中随机抽取的743名15至19岁女孩样本中,研究它们与性风险标志物(艾滋病毒和/或单纯疱疹病毒2型感染)之间的关联。使用多变量逻辑回归来评估教育状况在解释未婚孤儿与非孤儿相比不良性结局患病率较高方面的作用,并对可能的混杂因素进行调整。双亲孤儿的入学率和学业成绩明显低于非孤儿。母亲去世的孤儿辍学几率更高,不过在对近期流动情况进行调整后,这种关联消失了。教育状况与艾滋病毒/单纯疱疹病毒2型感染风险密切相关,但仅解释了双亲孤儿性风险的一小部分,并未解释母亲去世和父亲去世的孤儿的艾滋病毒/单纯疱疹病毒2型感染风险。为弱势家庭提供的中等学校总体参与率和学费援助水平较高,这可能缩小了高地地区孤儿与非孤儿之间的教育差距。然而,仍需进一步努力纠正持续存在的教育不平等现象,同时需要开展更多研究,以确定导致孤儿性风险的其他社会经济和情感因素,以便预防和支持方案能够满足这一不断增长的群体的需求。