Abstract: Purpose: To assess the relationship between school environment and health and behavior outcomes.
Methods: Data are from baseline and first follow-up of the HIV Prevention Trials Network (HPTN) 068 longitudinal trial established in 2012 of adolescent girls and young women in rural Mpumalanga Province, South Africa. Data from 2212 participants are included. We measured the association between four school environment domains: school resources, school safety, negative personal experiences, and school connectedness, and several health and behavior outcomes: depressive symptoms, low attendance, recent pregnancy, recent unprotected sex, transactional sex, and having an older romantic partner. We used a g-computation approach to estimate risk differences (RD) for the longitudinal relationship between the school environment (measured at the individual and school level) on individual health and behavior outcomes, controlling for baseline covariates.
Results: The mean age of participants at baseline was 15.4; mean age at first follow-up was 16.6. Individual baseline perceptions of an unsafe school environment (RD = 3.1 %, 95 % CI: 1.3-5.2 %) and more frequent negative experiences (RD = 4.0 %, 95 % CI: 2.0-5.9 %) were associated with higher absolute risk of depressive symptoms at follow-up. There was an overall trend toward higher risk of pregnancy, unprotected sex, and having an older partner among those who reported fewer school resources, lack of school safety, more negative personal experiences, and lack of school connectedness.
Conclusions: Our findings provide evidence of an overall trend toward higher risk of depression, pregnancy, unprotected sex, and having an older partner among those reporting a worse school environment across four school environment domains.
Competing Interests: Declaration of Competing Interest This study was funded by the National Institutes of Health (grant R01 MH110186) and by the National Institute of Allergy and Infectious Diseases, the National Institute of Mental Health and the National Institute on Drug Abuse (awards UM1 AI068619 (HPTN Leadership and Operations Center), UM1AI068617(HIV Prevention Trials Network Statistical and Data Management Center) and UM1AI068613 (HIV Prevention Trials Network Laboratory Center)). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This work was also supported by the National Institute of Mental Health (grant R01MH087118) and the Carolina Population Center (grant P2C HD050924). Additional support was provided by the Division of Intramural Research, National Institute of Allergy and Infectious Diseases. The MRC/Wits Rural Public Health and Health Transitions Research Unit and Agincourt Health and Socio-Demographic Surveillance System, a node of the South African Population Research Infrastructure Network (SAPRIN), is supported by the Department of Science and Innovation, the University of the Witwatersrand, and the Medical Research Council, South Africa, and previously the Wellcome Trust, UK (grants 058893/Z/99/A; 069683/Z/02/Z; 085477/Z/08/Z; 085477/B/08/Z).
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Processing Request
No Comments.