在校出勤和辍学对南非农村地区参加 HPTN 068 的年轻女性中 HIV 和 HSV-2 感染事件的影响。
The effect of school attendance and school dropout on incident HIV and HSV-2 among young women in rural South Africa enrolled in HPTN 068.
机构信息
aDepartment of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA bMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa cDepartment of Maternal and Child Health, University of North Carolina, Chapel Hill, North Carolina, USA dEpidemiology and Global Health Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden eDepartment of Biostatistics, University of Washington fFred Hutchinson Cancer Research Center, Seattle, Washington gDepartment of Pathology, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA hINDEPTH Network, Accra, Ghana, West Africa iSchool of Health and Society, University of Wollongong, New South Wales, Australia jWits Reproductive Health and HIV Research Institute, University of the Witwatersrand, Johannesburg, South Africa.
出版信息
AIDS. 2017 Sep 24;31(15):2127-2134. doi: 10.1097/QAD.0000000000001584.
OBJECTIVE
To estimate the association between school attendance, school dropout, and risk of incident HIV and herpes simplex virus type 2 (HSV-2) infection among young women.
DESIGN
We used longitudinal data from a randomized controlled trial in rural Mpumalanga province, South Africa, to assess the association between school days attended, school dropout, and incident HIV and HSV-2 in young women aged 13-23 years.
METHODS
We examined inverse probability of exposure weighted survival curves and used them to calculate 1.5, 2.5, and 3.5-year risk differences and risk ratios for the effect of school attendance on incident HIV and HSV-2. A marginal structural Cox model was used to estimate hazard ratios for the effect of school attendance and school dropout on incident infection.
RESULTS
Risk of infection increased over time as young women aged, and was higher in young women with low school attendance (<80% school days) compared with high (≥80% school days). Young women with low attendance were more likely to acquire HIV [hazard ratio (HR): 2.97; 95% confidence interval (CI): 1.62, 5.45] and HSV-2 (HR: 2.47; 95% CI: 1.46, 4.17) over the follow-up period than young women with high attendance. Similarly, young women who dropped out of school had a higher weighted hazard of both HIV (HR 3.25 95% CI: 1.67, 6.32) and HSV-2 (HR 2.70; 95% CI 1.59, 4.59).
CONCLUSION
Young women who attend more school days and stay in school have a lower risk of incident HIV and HSV-2 infection. Interventions to increase frequency of school attendance and prevent dropout should be promoted to reduce risk of infection.
目的
评估在校时间、辍学与年轻女性 HIV 和单纯疱疹病毒 2 型（HSV-2）感染风险之间的关联。
设计
我们使用南非姆普马兰加省农村地区一项随机对照试验的纵向数据，评估在校天数、辍学与 13-23 岁年轻女性 HIV 和 HSV-2 感染之间的关联。
方法
我们检查了反概率暴露加权生存曲线，并使用这些曲线计算了在校时间对 HIV 和 HSV-2 感染的 1.5、2.5 和 3.5 年风险差异和风险比。使用边缘结构 Cox 模型估计了在校时间和辍学对感染影响的风险比。
结果
随着年轻女性年龄的增长，感染风险随着时间的推移而增加，低在校出勤率（<80%的上课天数）的年轻女性比高在校出勤率（≥80%的上课天数）的年轻女性感染风险更高。低出勤率的年轻女性在随访期间更有可能感染 HIV[风险比（HR）：2.97；95%置信区间（CI）：1.62，5.45]和 HSV-2（HR：2.47；95%CI：1.46，4.17）。同样，辍学的年轻女性感染 HIV（HR 3.25 95%CI：1.67，6.32）和 HSV-2（HR 2.70；95%CI 1.59，4.59）的加权风险更高。
结论
在校时间较长且在校的年轻女性感染 HIV 和 HSV-2 的风险较低。应推广增加在校频率和预防辍学的干预措施，以降低感染风险。
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