Screening and supporting through schools: educational experiences and needs of adolescents living with HIV in a South African cohort

dc.contributor.authorToska, Elona
dc.contributor.authorCluver, Lucie
dc.contributor.authorOrkin, Mark
dc.contributor.authorBains, Anurita
dc.contributor.authorSherr, Lorraine
dc.contributor.authorBerezin, McKenzie
dc.contributor.authorGulaid, Laurie
dc.date.accessioned2019-03-11T13:50:41Z
dc.date.available2019-03-11T13:50:41Z
dc.date.issued2019-03-06
dc.date.updated2019-03-10T04:22:12Z
dc.description.abstractBackground Many adolescents living with HIV remain disconnected from care, especially in high-prevalence settings. Slow progressors–adolescents infected perinatally who survive without access to lifesaving treatment–remain unidentified and disconnected from heath systems, especially in high-prevalence settings. This study examines differences in educational outcomes for ALHIV, in order to i) identify educational markers for targeting HIV testing, counselling and linkages to care, and ii) to identify essential foci of educational support for ALHIV. Methods Quantitative interviews with N = 1063 adolescents living with HIV and N = 456 HIV-free community control adolescents (10–19 year olds) included educational experiences (enrolment, fee-free school, school feeding schemes, absenteeism, achievement), physical health, cognitive difficulties, mental health challenges (depression, stigma, and trauma), missing school to attend clinic appointments, and socio-demographic characteristics. Voluntary informed consent was obtained from adolescents and caregivers (when adolescent < 18 years old). Analyses included multivariate logistic regressions, controlling for socio-demographic covariates, and structural equation modelling using STATA15. Results ALHIV reported accessing educational services (enrolment, free schools, school feeding schemes) at the same rates as other adolescents (94, 30, and 92% respectively), suggesting that school is a valuable site for identification. Living with HIV was associated with poorer attendance (aOR = 1.7 95%CI1.1–2.6) and educational delay (aOR1.7 95%CI1.3–2.2). Adolescents who reported educational delay were more likely to be older, male, chronically sick and report more cognitive difficulties. A path model with excellent model fit (RMSEA = 0.027, CFI 0.984, TLI 0.952) indicated that living with HIV was associated with a series of poor physical, mental and cognitive health issues which led to worse educational experiences. Conclusion Schools may provide an important opportunity to identify unreached adolescents living with HIV and link them into care, focusing on adolescents with poor attendance, frequent sickness, low mood and slow learning. Key school-based markers for identifying unreached adolescents living with HIV may be low attendance, frequent sickness, low mood and slow learning. Improved linkages to care for adolescents living with HIV, in particular educational support services, are necessary to support scholastic achievement and long-term well-being, by helping them to cope with physical, emotional and cognitive difficulties.
dc.identifier.apacitationToska, E., Cluver, L., Orkin, M., Bains, A., Sherr, L., Berezin, M., & Gulaid, L. (2019). Screening and supporting through schools: educational experiences and needs of adolescents living with HIV in a South African cohort. http://hdl.handle.net/11427/29916en_ZA
dc.identifier.chicagocitationToska, Elona, Lucie Cluver, Mark Orkin, Anurita Bains, Lorraine Sherr, McKenzie Berezin, and Laurie Gulaid "Screening and supporting through schools: educational experiences and needs of adolescents living with HIV in a South African cohort." (2019) http://hdl.handle.net/11427/29916en_ZA
dc.identifier.citationToska, E., Cluver, L., Orkin, M., Bains, A., Sherr, L., Berezin, M., & Gulaid, L. (2019). Screening and supporting through schools: educational experiences and needs of adolescents living with HIV in a South African cohort. BMC Public Health, 19(1):272. DOI: 10.1186/s12889-019-6580-0.
dc.identifier.ris TY - Journal Article AU - Toska, Elona AU - Cluver, Lucie AU - Orkin, Mark AU - Bains, Anurita AU - Sherr, Lorraine AU - Berezin, McKenzie AU - Gulaid, Laurie AB - Background Many adolescents living with HIV remain disconnected from care, especially in high-prevalence settings. Slow progressors–adolescents infected perinatally who survive without access to lifesaving treatment–remain unidentified and disconnected from heath systems, especially in high-prevalence settings. This study examines differences in educational outcomes for ALHIV, in order to i) identify educational markers for targeting HIV testing, counselling and linkages to care, and ii) to identify essential foci of educational support for ALHIV. Methods Quantitative interviews with N = 1063 adolescents living with HIV and N = 456 HIV-free community control adolescents (10–19 year olds) included educational experiences (enrolment, fee-free school, school feeding schemes, absenteeism, achievement), physical health, cognitive difficulties, mental health challenges (depression, stigma, and trauma), missing school to attend clinic appointments, and socio-demographic characteristics. Voluntary informed consent was obtained from adolescents and caregivers (when adolescent < 18 years old). Analyses included multivariate logistic regressions, controlling for socio-demographic covariates, and structural equation modelling using STATA15. Results ALHIV reported accessing educational services (enrolment, free schools, school feeding schemes) at the same rates as other adolescents (94, 30, and 92% respectively), suggesting that school is a valuable site for identification. Living with HIV was associated with poorer attendance (aOR = 1.7 95%CI1.1–2.6) and educational delay (aOR1.7 95%CI1.3–2.2). Adolescents who reported educational delay were more likely to be older, male, chronically sick and report more cognitive difficulties. A path model with excellent model fit (RMSEA = 0.027, CFI 0.984, TLI 0.952) indicated that living with HIV was associated with a series of poor physical, mental and cognitive health issues which led to worse educational experiences. Conclusion Schools may provide an important opportunity to identify unreached adolescents living with HIV and link them into care, focusing on adolescents with poor attendance, frequent sickness, low mood and slow learning. Key school-based markers for identifying unreached adolescents living with HIV may be low attendance, frequent sickness, low mood and slow learning. Improved linkages to care for adolescents living with HIV, in particular educational support services, are necessary to support scholastic achievement and long-term well-being, by helping them to cope with physical, emotional and cognitive difficulties. DA - 2019-03-06 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PY - 2019 T1 - Screening and supporting through schools: educational experiences and needs of adolescents living with HIV in a South African cohort TI - Screening and supporting through schools: educational experiences and needs of adolescents living with HIV in a South African cohort UR - http://hdl.handle.net/11427/29916 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12889-019-6580-0
dc.identifier.urihttp://hdl.handle.net/11427/29916
dc.identifier.vancouvercitationToska E, Cluver L, Orkin M, Bains A, Sherr L, Berezin M, et al. Screening and supporting through schools: educational experiences and needs of adolescents living with HIV in a South African cohort. 2019; http://hdl.handle.net/11427/29916.en_ZA
dc.language.isoen
dc.publisherBioMed Central
dc.rights.holderThe Author(s).
dc.subject.otherHIV/AIDS
dc.subject.otherAdolescents
dc.subject.otherEducation
dc.subject.otherHealth
dc.subject.otherPath analyses
dc.subject.otherSouth Africa
dc.titleScreening and supporting through schools: educational experiences and needs of adolescents living with HIV in a South African cohort
dc.typeJournal Article
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