Supporting Adolescent Orphan Girls to Stay in School as HIV Risk Prevention: Evidence From a Randomized Controlled Trial in Zimbabwe
Supporting Adolescent Orphan Girls to Stay in School as HIV Risk Prevention: Evidence From a Randomized Controlled Trial in Zimbabwe
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DOI：
10.2105/ajph.2010.300042
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发表时间：
2011-06-01
影响因子：
12.7
通讯作者：
Halpern, Carolyn
中科院分区：
文献类型：
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作者：
Hallfors, Denise;Cho, Hyunsan;Halpern, Carolyn
目标。我们在津巴布韦东部农村地区进行了一项随机对照试验，测试了为孤儿少女入学提供综合支持是否能降低艾滋病风险。于2007年秋季邀请25所小学六年级的所有孤女参加研究（n=329）。小学被随机分配到条件中。所有小学都实行普遍的每日供餐计划；参与干预的人收到了费用、制服和一名学校助理来监督出勤和解决问题。我们进行了年度调查，并收集了关于辍学率、结婚率和怀孕率的额外信息。我们使用3个时间点的广义估计方程分析数据，控制学校和年龄作为基线。两年后，干预使辍学率降低了82%，结婚率降低了63%。与对照组的参与者相比，干预组表现出更强的学校关系、更好的未来预期、更公平的性别态度以及对性别后果的更多关注。我们发现有希望的证据表明，全面的学校支持可以降低孤儿女孩感染艾滋病毒的风险。进一步的研究，包括剂量反应评估、成本效益以及HIV和单纯疱疹病毒2型生物标志物的测量，是有必要的。[J] .中华卫生杂志，2011;31(1):1082-1088。doi: 10.2105 / AJPH.2010.300042)
Objectives. Using a randomized controlled trial in rural eastern Zimbabwe, we tested whether comprehensive support to keep orphan adolescent girls in school could reduce HIV risk.Methods. All orphan girls in grade 6 in 25 primary schools were invited to participate in the study in fall 2007 (n=329). Primary schools were randomized to condition. All primary schools received a universal daily feeding program; intervention participants received fees, uniforms, and a school-based helper to monitor attendance and resolve problems. We conducted annual surveys and collected additional information on school dropout, marriage, and pregnancy rates. We analyzed data using generalized estimating equations over 3 time points, controlling for school and age at baseline.Results. The intervention reduced school dropout by 82% and marriage by 63% after 2 years. Compared with control participants, the intervention group reported greater school bonding, better future expectations, more equitable gender attitudes, and more concerns about the consequences of sex.Conclusions. We found promising evidence that comprehensive school support may reduce HIV risk for orphan girls. Further study, including assessment of dose response, cost benefit, and HIV and herpes simplex virus 2 biomarker measurement, is warranted. (Am J Public Health. 2011;101: 1082-1088. doi:10.2105/AJPH.2010.300042)