Pufall Erica L, Nyamukapa Constance, Eaton Jeffrey W, Campbell Catherine, Skovdal Morten, Munyati Shungu, Robertson Laura, Gregson Simon
a Department of Infectious Disease Epidemiology , Imperial College London , London , UK.
AIDS Care. 2014;26(9):1136-43. doi: 10.1080/09540121.2014.892564. Epub 2014 Mar 14.
Little is known about how HIV impacts directly and indirectly on receiving, or particularly succeeding in, education in sub-Saharan Africa. To address this gap, we used multivariable logistic regression to determine the correlation between education outcomes in youth (aged 15-24) (being in the correct grade-for-age, primary school completion and having at least five "O" level passes) and being HIV-positive; having an HIV-positive parent; being a young carer; or being a maternal, paternal or double orphan, in five rounds (1998-2011) of a general population survey from eastern Zimbabwe. The fifth survey round (2009-2011) included data on children aged 6-17, which were analysed for the impacts of the above risk factors on regular attendance in primary and secondary schools and being in the correct grade-for-age. For data pooled over all rounds, being HIV-positive had no association with primary school completion, "O" level passes, or being in the correct grade-for-age in adolescents aged 16-17 years. Additionally, HIV status had no significant association with any education outcomes in children aged 6-17 surveyed in 2009-2011. In 2009-2011, being a young carer was associated with lower attendance in secondary school (69% vs. 85%, AOR: 0.44; p=0.02), whilst being a maternal (75% vs. 83%, AOR: 0.67; p<0.01), paternal (76% vs. 83%, AOR: 0.67; p=0.02) or double (75% vs. 83%, AOR: 0.68; p=0.02) orphan was associated with decreased odds of being in the correct grade-for-age. All forms of orphanhood also significantly decreased the odds of primary school completion in youths surveyed from 1998 to 2011 (all p<0.01). We found no evidence that HIV status affects education but further evidence that orphans do experience worse education outcomes than other children. Combination approaches that provide incentives for children to attend school and equip schools with tools to support vulnerable children may be most effective in improving education outcomes and should be developed and evaluated.
关于艾滋病毒如何直接和间接地影响撒哈拉以南非洲地区的教育接受情况，尤其是教育成就，目前所知甚少。为了填补这一空白，我们利用多变量逻辑回归来确定在津巴布韦东部进行的五轮（1998 - 2011年）普通人群调查中，青年（15 - 24岁）的教育成果（适龄就读正确年级、小学毕业以及至少通过五门“O”水准考试）与艾滋病毒呈阳性；有艾滋病毒呈阳性的父母；是年轻照顾者；或是母亲、父亲或双亲孤儿之间的相关性。第五轮调查（2009 - 2011年）包含了6 - 17岁儿童的数据，分析了上述风险因素对中小学正常出勤和适龄就读正确年级的影响。对于所有轮次汇总的数据，艾滋病毒呈阳性与16 - 17岁青少年的小学毕业、“O”水准考试通过情况或适龄就读正确年级均无关联。此外，艾滋病毒感染状况与2009 - 2011年接受调查的6 - 17岁儿童的任何教育成果均无显著关联。在2009 - 2011年，作为年轻照顾者与中学出勤率较低相关（69%对85%，调整后比值比：0.44；p = 0.02），而作为母亲（75%对83%，调整后比值比：0.67；p < 0.01）、父亲（76%对83%，调整后比值比：0.67；p = 0.02）或双亲（75%对83%，调整后比值比：0.68；p = 0.02）孤儿与适龄就读正确年级的几率降低相关。在1998年至2011年接受调查的青年中，所有形式的孤儿身份也显著降低了小学毕业的几率（所有p < 0.01）。我们没有发现证据表明艾滋病毒感染状况会影响教育，但有进一步证据表明孤儿的教育成果确实比其他儿童更差。提供激励措施促使儿童上学并为学校配备支持弱势儿童的工具的综合方法，可能在改善教育成果方面最为有效，应该加以开发和评估。
