PMID- 29847479
OWN - NLM
STAT- MEDLINE
DCOM- 20191028
LR  - 20240329
IS  - 1944-7884 (Electronic)
IS  - 1525-4135 (Print)
IS  - 1525-4135 (Linking)
VI  - 79
IP  - 1
DP  - 2018 Sep 1
TI  - Does Partner Selection Mediate the Relationship Between School Attendance and 
      HIV/Herpes Simplex Virus-2 Among Adolescent Girls and Young Women in South 
      Africa: An Analysis of HIV Prevention Trials Network 068 Data.
PG  - 20-27
LID - 10.1097/QAI.0000000000001766 [doi]
AB  - OBJECTIVE: School attendance prevents HIV and herpes simplex virus-2 (HSV-2) in 
      adolescent girls and young women, but the mechanisms to explain this relationship 
      remain unclear. Our study assesses the extent to which characteristics of sex 
      partners, partner age, and number mediate the relationship between attendance and 
      risk of infection in adolescent girls and young women in South Africa. DESIGN: We 
      use longitudinal data from the HIV Prevention Trials Network 068 randomized 
      controlled trial in rural South Africa, where girls were enrolled in early 
      adolescence and followed in the main trial for more than 3 years. We examined 
      older partners and the number of partners as possible mediators. METHODS: We used 
      the parametric g-formula to estimate 4-year risk differences for the effect of 
      school attendance on the cumulative incidence of HIV/HSV-2 overall and the 
      controlled direct effect (CDE) for mediation. We examined mediation separately 
      and jointly for the mediators of interest. RESULTS: We found that young women 
      with high attendance in school had a lower cumulative incidence of HIV compared 
      with those with low attendance (risk difference = -1.6%). Partner age difference 
      (CDE = -1.2%) and the number of partners (CDE = -0.4%) mediated a large portion 
      of this effect. In fact, when we accounted for the mediators jointly, the effect 
      of schooling on HIV was almost removed, showing full mediation (CDE = -0.3%). The 
      same patterns were observed for the relationship between school attendance and 
      cumulative incidence of HSV-2 infection. CONCLUSION: Increasing school attendance 
      reduces the risk of acquiring HIV and HSV-2. Our results indicate the importance 
      of school attendance in reducing partner number and partner age difference in 
      this relationship.
FAU - Stoner, Marie C D
AU  - Stoner MCD
AD  - Department of Epidemiology, University of North Carolina, Chapel Hill, NC.
FAU - Edwards, Jessie K
AU  - Edwards JK
AD  - Department of Epidemiology, University of North Carolina, Chapel Hill, NC.
FAU - Miller, William C
AU  - Miller WC
AD  - Division of Epidemiology, The Ohio State University, Columbus, OH.
FAU - Aiello, Allison E
AU  - Aiello AE
AD  - Department of Epidemiology, University of North Carolina, Chapel Hill, NC.
FAU - Halpern, Carolyn T
AU  - Halpern CT
AD  - Department of Maternal and Child Health, University of North Carolina, Chapel 
      Hill, NC.
FAU - Julien, Aimee
AU  - Julien A
AD  - Department of Epidemiology, University of North Carolina, Chapel Hill, NC.
AD  - MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), 
      School of Public Health, Faculty of Health Sciences, University of the 
      Witwatersrand, Johannesburg, South Africa.
FAU - Rucinski, Katherine B
AU  - Rucinski KB
AD  - Department of Epidemiology, University of North Carolina, Chapel Hill, NC.
FAU - Selin, Amanda
AU  - Selin A
AD  - Department of Epidemiology, University of North Carolina, Chapel Hill, NC.
FAU - Twine, Rhian
AU  - Twine R
AD  - MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), 
      School of Public Health, Faculty of Health Sciences, University of the 
      Witwatersrand, Johannesburg, South Africa.
FAU - Hughes, James P
AU  - Hughes JP
AD  - Department of Biostatistics, University of Washington, Seattle, WA.
AD  - Fred Hutchinson Cancer Research Center, Seattle, WA.
FAU - Wang, Jing
AU  - Wang J
AD  - Fred Hutchinson Cancer Research Center, Seattle, WA.
FAU - Agyei, Yaw
AU  - Agyei Y
AD  - School of Medicine, Johns Hopkins University, Baltimore, MD.
FAU - Gomez-Olive, Francesc Xavier
AU  - Gomez-Olive FX
AD  - MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), 
      School of Public Health, Faculty of Health Sciences, University of the 
      Witwatersrand, Johannesburg, South Africa.
AD  - INDEPTH Network, Accra, Ghana.
FAU - Wagner, Ryan G
AU  - Wagner RG
AD  - MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), 
      School of Public Health, Faculty of Health Sciences, University of the 
      Witwatersrand, Johannesburg, South Africa.
AD  - Department of Public Health and Clinical Medicine, Epidemiology and Global Health 
      Unit, Umea University, Umea, Sweden.
FAU - Laeyendecker, Oliver
AU  - Laeyendecker O
AD  - Division of Intramural Research, National Institute of Allergy and Infectious 
      Diseases, National Institutes of Health, Baltimore, MD.
FAU - Macphail, Catherine
AU  - Macphail C
AD  - MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), 
      School of Public Health, Faculty of Health Sciences, University of the 
      Witwatersrand, Johannesburg, South Africa.
AD  - School of Health and Society, University of Wollongong, Wollongong, New South 
      Wales, Australia.
AD  - Wits Reproductive Health and HIV Research Institute, University of the 
      Witwatersrand, Johannesburg, South Africa.
FAU - Kahn, Kathleen
AU  - Kahn K
AD  - MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), 
      School of Public Health, Faculty of Health Sciences, University of the 
      Witwatersrand, Johannesburg, South Africa.
AD  - INDEPTH Network, Accra, Ghana.
AD  - Department of Public Health and Clinical Medicine, Epidemiology and Global Health 
      Unit, Umea University, Umea, Sweden.
FAU - Pettifor, Audrey
AU  - Pettifor A
AD  - Department of Epidemiology, University of North Carolina, Chapel Hill, NC.
AD  - MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), 
      School of Public Health, Faculty of Health Sciences, University of the 
      Witwatersrand, Johannesburg, South Africa.
LA  - eng
GR  - UM1 AI069423/AI/NIAID NIH HHS/United States
GR  - T32 AI007001/AI/NIAID NIH HHS/United States
GR  - R01 MH110186/MH/NIMH NIH HHS/United States
GR  - 069683/Z/02/Z/WT_/Wellcome Trust/United Kingdom
GR  - R01 MH087118/MH/NIMH NIH HHS/United States
GR  - MRC_/Medical Research Council/United Kingdom
GR  - 085477/Z/08/Z/WT_/Wellcome Trust/United Kingdom
GR  - 058893/Z/99/A/WT_/Wellcome Trust/United Kingdom
GR  - UM1 AI068619/AI/NIAID NIH HHS/United States
GR  - UM1 AI068613/AI/NIAID NIH HHS/United States
GR  - Wellcome Trust/United Kingdom
GR  - R24 HD050924/HD/NICHD NIH HHS/United States
GR  - P2C HD050924/HD/NICHD NIH HHS/United States
GR  - 085477/B/08/Z/WT_/Wellcome Trust/United Kingdom
GR  - UM1 AI068617/AI/NIAID NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Acquir Immune Defic Syndr
JT  - Journal of acquired immune deficiency syndromes (1999)
JID - 100892005
SB  - IM
MH  - Adolescent
MH  - Clinical Trials, Phase III as Topic
MH  - Female
MH  - HIV Infections/epidemiology/*prevention & control
MH  - Herpes Genitalis/epidemiology/*prevention & control
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Randomized Controlled Trials as Topic
MH  - *Schools
MH  - *Sexual Partners
MH  - South Africa/epidemiology
MH  - Young Adult
PMC - PMC6092209
MID - NIHMS969310
COIS- Declaration of Interests: We declare no competing interests.
EDAT- 2018/05/31 06:00
MHDA- 2019/10/29 06:00
PMCR- 2019/09/01
CRDT- 2018/05/31 06:00
PHST- 2018/05/31 06:00 [pubmed]
PHST- 2019/10/29 06:00 [medline]
PHST- 2018/05/31 06:00 [entrez]
PHST- 2019/09/01 00:00 [pmc-release]
AID - 10.1097/QAI.0000000000001766 [doi]
PST - ppublish
SO  - J Acquir Immune Defic Syndr. 2018 Sep 1;79(1):20-27. doi: 
      10.1097/QAI.0000000000001766.