Denise Dion Hallfors1, Hyunsan Cho2, Simbarashe Rusakaniko3, John Mapfumo4, Bonita Iritani2, Lei Zhang2, Winnie Luseno2, Ted Miller5. 1. The Pacific Institute for Research and Evaluation, Chapel Hill, North Carolina. Electronic address: Hallfors@pire.org. 2. The Pacific Institute for Research and Evaluation, Chapel Hill, North Carolina. 3. Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe. 4. Faculty of Education, Africa University, Mutare, Zimbabwe. 5. The Pacific Institute for Research and Evaluation, Beltsville, Maryland.
Abstract
PURPOSE: We examine effects of school support as a structural HIV prevention intervention for adolescent female orphans in Zimbabwe after 5 years. METHODS:Three hundred twenty-eight orphan adolescent girls were followed in a clustered randomized controlled trial from 2007 to 2010. The experimental group received school fees, uniforms, and school supplies and were assigned a school-based "helper." In 2011-2012, the control group received delayed partial treatment of school fees only. At the final data point in 2012, survey, HIV, and Herpes Simplex Virus Type 2 (HSV-2) biomarker data were collected from approximately 88% of the sample. Bivariate and multivariate analyses were conducted on end point outcomes, controlling for age, religious affiliation, and baseline socioeconomic status. RESULTS: The two groups did not differ on HIV or HSV-2 biomarkers. The comprehensive 5-year intervention continued to reduce the likelihood of marriage, improve school retention, improve socioeconomic status (food security), and marginally maintain gains in quality of life, even after providing school fees to the control group. CONCLUSIONS: Paying school fees and expenses resulted in significant improvements in life outcomes for orphan adolescent girls. Biological evidence of HIV infection prevention, however, was not observed. Our study adds to the growing body of research on school support as HIV prevention for girls in sub-Saharan Africa, but as yet, no clear picture of effectiveness has emerged.
RCT Entities:
PURPOSE: We examine effects of school support as a structural HIV prevention intervention for adolescent female orphans in Zimbabwe after 5 years. METHODS: Three hundred twenty-eight orphan adolescent girls were followed in a clustered randomized controlled trial from 2007 to 2010. The experimental group received school fees, uniforms, and school supplies and were assigned a school-based "helper." In 2011-2012, the control group received delayed partial treatment of school fees only. At the final data point in 2012, survey, HIV, and Herpes Simplex Virus Type 2 (HSV-2) biomarker data were collected from approximately 88% of the sample. Bivariate and multivariate analyses were conducted on end point outcomes, controlling for age, religious affiliation, and baseline socioeconomic status. RESULTS: The two groups did not differ on HIV or HSV-2 biomarkers. The comprehensive 5-year intervention continued to reduce the likelihood of marriage, improve school retention, improve socioeconomic status (food security), and marginally maintain gains in quality of life, even after providing school fees to the control group. CONCLUSIONS: Paying school fees and expenses resulted in significant improvements in life outcomes for orphan adolescent girls. Biological evidence of HIV infection prevention, however, was not observed. Our study adds to the growing body of research on school support as HIV prevention for girls in sub-Saharan Africa, but as yet, no clear picture of effectiveness has emerged.
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