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Systematic review exploring time trends in the association between educational attainment and risk of HIV infection in sub-Saharan Africa.

Publication ,  Journal Article
Hargreaves, JR; Bonell, CP; Boler, T; Boccia, D; Birdthistle, I; Fletcher, A; Pronyk, PM; Glynn, JR
Published in: AIDS (London, England)
January 2008

To assess the evidence that the association between educational attainment and risk of HIV infection is changing over time in sub-Saharan Africa.Systematic review of published peer-reviewed articles. Articles were identified that reported original data comparing individually measured educational attainment and HIV status among at least 300 individuals representative of the general population of countries or regions of sub-Saharan Africa. Statistical analyses were required to adjust for potential confounders but not over-adjust for variables on the causal pathway.Approximately 4000 abstracts and 1200 full papers were reviewed. Thirty-six articles were included in the study, containing data on 72 discrete populations from 11 countries between 1987 and 2003, representing over 200,000 individuals. Studies on data collected prior to 1996 generally found either no association or the highest risk of HIV infection among the most educated. Studies conducted from 1996 onwards were more likely to find a lower risk of HIV infection among the most educated. Where data over time were available, HIV prevalence fell more consistently among highly educated groups than among less educated groups, in whom HIV prevalence sometimes rose while overall population prevalence was falling. In several populations, associations suggesting greater HIV risk in the more educated at earlier time points were replaced by weaker associations later.HIV infections appear to be shifting towards higher prevalence among the least educated in sub-Saharan Africa, reversing previous patterns. Policy responses that ensure HIV-prevention measures reach all strata of society and increase education levels are urgently needed.

Duke Scholars

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Published In

AIDS (London, England)

DOI

EISSN

1473-5571

ISSN

0269-9370

Publication Date

January 2008

Volume

22

Issue

3

Start / End Page

403 / 414

Related Subject Headings

  • Virology
  • Time Factors
  • Risk Factors
  • Prevalence
  • Poverty
  • Male
  • Humans
  • HIV-1
  • HIV Infections
  • Female
 

Citation

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Hargreaves, J. R., Bonell, C. P., Boler, T., Boccia, D., Birdthistle, I., Fletcher, A., … Glynn, J. R. (2008). Systematic review exploring time trends in the association between educational attainment and risk of HIV infection in sub-Saharan Africa. AIDS (London, England), 22(3), 403–414. https://doi.org/10.1097/qad.0b013e3282f2aac3
Hargreaves, James R., Christopher P. Bonell, Tania Boler, Delia Boccia, Isolde Birdthistle, Adam Fletcher, Paul M. Pronyk, and Judith R. Glynn. “Systematic review exploring time trends in the association between educational attainment and risk of HIV infection in sub-Saharan Africa.AIDS (London, England) 22, no. 3 (January 2008): 403–14. https://doi.org/10.1097/qad.0b013e3282f2aac3.
Hargreaves JR, Bonell CP, Boler T, Boccia D, Birdthistle I, Fletcher A, et al. Systematic review exploring time trends in the association between educational attainment and risk of HIV infection in sub-Saharan Africa. AIDS (London, England). 2008 Jan;22(3):403–14.
Hargreaves, James R., et al. “Systematic review exploring time trends in the association between educational attainment and risk of HIV infection in sub-Saharan Africa.AIDS (London, England), vol. 22, no. 3, Jan. 2008, pp. 403–14. Epmc, doi:10.1097/qad.0b013e3282f2aac3.
Hargreaves JR, Bonell CP, Boler T, Boccia D, Birdthistle I, Fletcher A, Pronyk PM, Glynn JR. Systematic review exploring time trends in the association between educational attainment and risk of HIV infection in sub-Saharan Africa. AIDS (London, England). 2008 Jan;22(3):403–414.

Published In

AIDS (London, England)

DOI

EISSN

1473-5571

ISSN

0269-9370

Publication Date

January 2008

Volume

22

Issue

3

Start / End Page

403 / 414

Related Subject Headings

  • Virology
  • Time Factors
  • Risk Factors
  • Prevalence
  • Poverty
  • Male
  • Humans
  • HIV-1
  • HIV Infections
  • Female