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Is education the link between orphanhood and HIV/HSV-2 risk among female adolescents in urban Zimbabwe?


  • Birdthistle, Isolde
  • Floyd, Sian
  • Nyagadza, Auxillia
  • Mudziwapasi, Netsai
  • Gregson, Simon
  • Glynn, Judith R.


As the population of orphans grows in AIDS-affected settings, recent studies describe a heightened risk of HIV and sexual risk behaviours among adolescent orphans compared to their non-orphaned peers. This study explores the role of education in explaining the excess sexual risk previously documented among unmarried female orphans in urban Zimbabwe. School attendance and attainment were assessed by type of orphanhood, and for their association with markers of sexual risk (HIV and/or HSV-2 infection) among 743 participants drawn from a random sample of 15-19-year-old girls identified in a cross-sectional survey in Highfield, Harare, in 2004. Multivariable logistic regression was used to assess the role of educational status in explaining the higher prevalence of adverse sexual outcomes among unmarried orphans compared to non-orphans, adjusting for possible confounders. Double orphans had significantly lower educational attendance and attainment than non-orphans. Maternal orphans had higher odds of school drop-out, although this association disappeared when adjusted for recent mobility. Educational status was strongly associated with HIV/HSV-2 risk, but explained only a small part of double orphans' sexual risk and did not explain the HIV/HSV-2 risk of maternal and paternal orphans. High overall levels of secondary school participation and school fee assistance provided to vulnerable families may have reduced the schooling disparities between orphans and non-orphans in Highfield. However, further efforts are needed to rectify the schooling inequities that persist, while additional research is needed to identify other socio-economic and emotional factors driving orphans' sexual risk so that prevention and support programmes can meet the needs of this growing population.

Suggested Citation

  • Birdthistle, Isolde & Floyd, Sian & Nyagadza, Auxillia & Mudziwapasi, Netsai & Gregson, Simon & Glynn, Judith R., 2009. "Is education the link between orphanhood and HIV/HSV-2 risk among female adolescents in urban Zimbabwe?," Social Science & Medicine, Elsevier, vol. 68(10), pages 1810-1818, May.
  • Handle: RePEc:eee:socmed:v:68:y:2009:i:10:p:1810-1818

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    References listed on IDEAS

    1. repec:pri:rpdevs:case_paxson_orphansafrica is not listed on IDEAS
    2. Anne Case & Christina Paxson & Joseph Ableidinger, 2004. "Orphans in Africa: parental death, poverty, and school enrollment," Demography, Springer;Population Association of America (PAA), vol. 41(3), pages 483-508, August.
    3. Nyamukapa, Constance & Gregson, Simon, 2005. "Extended family's and women's roles in safeguarding orphans' education in AIDS-afflicted rural Zimbabwe," Social Science & Medicine, Elsevier, vol. 60(10), pages 2155-2167, May.
    4. David Evans & Edward Miguel, 2007. "Orphans and schooling in africa: a longitudinal analysis," Demography, Springer;Population Association of America (PAA), vol. 44(1), pages 35-57, February.
    5. Bicego, George & Rutstein, Shea & Johnson, Kiersten, 2003. "Dimensions of the emerging orphan crisis in sub-Saharan Africa," Social Science & Medicine, Elsevier, vol. 56(6), pages 1235-1247, March.
    6. repec:pri:cheawb:case_paxson_orphansafrica is not listed on IDEAS
    7. 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.
    8. repec:pri:rpdevs:case_paxson_orphansafrica.pdf is not listed on IDEAS
    9. repec:pri:cheawb:case_paxson_orphansafrica.pdf is not listed on IDEAS
    10. Anne Case & Cally Ardington, 2006. "The impact of parental death on school outcomes: Longitudinal evidence from South Africa," Demography, Springer;Population Association of America (PAA), vol. 43(3), pages 401-420, August.
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    Cited by:

    1. Cluver, Lucie & Orkin, Mark & Boyes, Mark E. & Sherr, Lorraine & Makasi, Daphne & Nikelo, Joy, 2013. "Pathways from parental AIDS to child psychological, educational and sexual risk: Developing an empirically-based interactive theoretical model," Social Science & Medicine, Elsevier, vol. 87(C), pages 185-193.
    2. Ismayilova, Leyla & Ssewamala, Fred & Mooers, Elizabeth & Nabunya, Proscovia & Sheshadri, Srividya, 2012. "Imagining the future: Community perceptions of a family-based economic empowerment intervention for AIDS-orphaned adolescents in Uganda," Children and Youth Services Review, Elsevier, vol. 34(10), pages 2042-2051.
    3. Pufall, Erica & Eaton, Jeffrey W. & Nyamukapa, Constance & Schur, Nadine & Takaruza, Albert & Gregson, Simon, 2016. "The relationship between parental education and children’s schooling in a time of economic turmoil: The case of East Zimbabwe, 2001 to 2011," International Journal of Educational Development, Elsevier, vol. 51(C), pages 125-134.
    4. Shelley Clark & Cassandra Cotton, 2013. "Transitions to adulthood in urban Kenya," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 28(37), pages 1053-1092, May.


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