AEGiS-15IAC: Household wealth, school enrolment and risk of HIV infection; baseline results from a community randomised trial of a poverty alleviation initiative in rural South Africa.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Household wealth, school enrolment and risk of HIV infection; baseline results from a community randomised trial of a poverty alleviation initiative in rural South Africa.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. TuOrC1156)

Hargreaves JR, Morison LA, Porter JD, Makhubele MB, Kim JC, Watts C, Busza J, Pronyk PM
Rural AIDS and Development Action Research Programme, Acornhoek, South Africa

BACKGROUND: Household wealth might influence young peoples' risk of HIV infection through many pathways. Understanding this might help elucidate the potential role of poverty alleviation initiatives in HIV prevention. We examined whether current school enrolment might be a pathway linking household wealth and risk of HIV infection using data from an ongoing community randomised trial.

METHODS: The IMAGE study randomised 8 villages in 2001; 4 microcredit and gender/HIV training intervention, 4 comparison. A baseline survey collected sexual health and HIV infection data from individuals in randomly selected households. Household socioeconomic data were also collected. We investigated the relationship between school enrolment and household poverty levels, and examined whether they were related to sexual debut, condom use and risk of HIV infection using regression modelling.

RESULTS: 1964 individuals aged 14-25yrs from 1482 households were included in the analysis. 86% of individuals provided a sample for HIV testing with 9.3% males & 14.5% females HIV +ve. Continued school enrolment among both sexes was more common in the wealthiest households (adjusted Odds Ratio (aOR) 2.2, 95% CI 1.5-3.3, males and females combined). Females attending school were less likely to have started sexual activity than those of the same age who were not in school. Among the sexually active those in school were more likely to always use condoms. Those in school were at lower risk of HIV infection among both sexes (aOR 0.5, 95% CI 0.3-0.9). This association was weaker when only sexually active individuals were included in the analysis, but was not affected by reported condom use.

CONCLUSIONS: Attending school was associated with indicators of safer sexual behaviour and lower HIV prevalence. Young people from poorer households were less likely to be attending school. Successful poverty alleviation initiatives might improve school enrolment rates and reduce HIV infection rates in this setting.

Keywords: AEGIS, Family Characteristics, Residence Characteristics, HIV Infections, Poverty, Students, Prevalence, Acquired Immunodeficiency Syndrome, Sexual Behavior, Condoms, Socioeconomic Factors, HIV Seropositivity, South Africa, Humans, Female, Male

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TuOrC1156