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Trends in Socioeconomic Inequalities in HIV Prevalence among Young People in Seven Countries in Eastern and Southern Africa

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  • James R Hargreaves
  • Calum Davey
  • Elizabeth Fearon
  • Bernadette Hensen
  • Shari Krishnaratne

Abstract

Background: In Eastern and Southern Africa, HIV prevalence was highest among higher socioeconomic groups during the 1990s. It has been suggested that this is changing, with HIV prevalence falling among higher-educated groups while stable among lower-educated groups. A multi-country analysis has not been undertaken. Methods: We analysed data on socio-demographic factors and HIV infection from 14 nationally representative surveys of adults aged 15-24 (seven countries, two surveys each, 4-8 years apart). Sample sizes ranged from 2,408-12,082 (72,135 total). We used logistic regression to assess gender-stratified associations between highest educational level attended and HIV status in each survey, adjusting for age and urban/rural setting. We tested for interactions with urban/rural setting and age. Our primary hypothesis was that higher education became less of a risk factor for HIV over time. We tested for interaction between survey-year and the education-HIV association in each country and all countries pooled. Findings: In Ethiopia and Malawi, HIV prevalence was higher in more educated women in both surveys. In Lesotho, Kenya and Zimbabwe, HIV prevalence was lower in higher educated women in both surveys. In Ethiopia, HIV prevalence fell among no and secondary educated women only (interaction p

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  • James R Hargreaves & Calum Davey & Elizabeth Fearon & Bernadette Hensen & Shari Krishnaratne, 2015. "Trends in Socioeconomic Inequalities in HIV Prevalence among Young People in Seven Countries in Eastern and Southern Africa," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-13, March.
    • Handle: RePEc:plo:pone00:0121775
    DOI: 10.1371/journal.pone.0121775
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    References listed on IDEAS

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    1. Peter J. Glick & David E. Sahn, 2008. "Are Africans Practicing Safer Sex? Evidence from Demographic and Health Surveys for Eight Countries," Economic Development and Cultural Change, University of Chicago Press, vol. 56(2), pages 397-439, January.
    2. Simon Gregson & Heather Waddell & Stephen Chandiwana, 2001. "School education and HIV control in sub-Saharan Africa: from discord to harmony?," Journal of International Development, John Wiley & Sons, Ltd., vol. 13(4), pages 467-485.
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    Cited by:

    1. Nonzwakazi P Ntombela & Tivani P Mashamba-Thompson & Andile N Mtshali & Desmond Kuupiel & Ayesha BM Kharsany, 2019. "HIV Risks in Sexual Networks of Heterosexual Men in South Africa," Global Journal of Health Science, Canadian Center of Science and Education, vol. 11(13), pages 146-146, December.
    2. Hadley, Craig & Maxfield, Amanda & Hruschka, Daniel, 2019. "Different forms of household wealth are associated with opposing risks for HIV infection in East Africa," World Development, Elsevier, vol. 113(C), pages 344-351.

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