Dissertation/Thesis Abstract

Education and Health Outcomes: Three Papers Examining the Influence of Education on HIV for Young Adults in Low- and Middle- Income Settings
by Pace, Jill E., Dr.P.H., Columbia University, 2019, 66; 13861055
Abstract (Summary)

Nearly 37 million people are living with HIV and there are an estimated 2.1 million new HIV infections each year, equating to 5,700 new infections per day. Approximately half of new HIV infections occur in Eastern and Southern Africa. Young people are at particularly high risk of HIV; 35% of new infections are among young people ages 15-24 years. In sub-Saharan Africa, 25% of new infections are among young women. Throughout the course of the HIV epidemic, research has described the associations between social structural and behavioral determinants of HIV acquisition. The influences of socioeconomic status, household characteristics, gender, geographical residence, and risky sexual behaviors on HIV acquisition are well reviewed in the literature. Evidence on the impact of education on factors that influence HIV acquisition is less robust and associations have changed over time as both education and the HIV epidemic have evolved.

Globally, access to education and educational attainment has increased over the past several decades. In developing countries, the number of years enrolled in school for both men and women has significantly increased. The impact of increased educational attainment has contributed to reductions in child mortality, improvements in reproductive health, and reduced HIV transmission. In many countries, the gap in education between men and women has reversed, with women now achieving higher levels of educational attainment than men. However, in several low and middle income countries, gender disparities persist. Global public health, development, and policy communities recognize the importance of education and its influence on health outcomes. Over the past decade, education has been highlighted in the Millennium Development Goals (MDG) and now is continuing as a priority for the Sustainable Development Goals (SDG) in the post 2015-agenda. The goal of MDG 2 was to achieve universal primary education for all children; building on this goal, SDG 4 focuses on quality education, ensuring inclusive and equitable education and promoting lifelong learning opportunities for all.

The goal of this dissertation is to highlight the importance of education by summarizing the current state of literature that reviews associations between education and HIV infection for adolescents in low- and middle- income countries and illuminating the key entry points for research, policy, and programming by examining the relationship of education on determinants of HIV infection for young people. This dissertation accomplishes the stated goal by: (1) Systematically reviewing associations between education and HIV infection for youth ages 13 – 24 years living in low- and middle- income countries (Chapter 1); (2) Examining the relationship between educational attainment on HIV acquisition for young adults ages 20 – 24 years in Rakai, Uganda (Chapter 2); and (3) Commenting on the pathways to HIV acquisition and identifying key entry points and best practices in policy and research to promote improved health outcomes for adolescents (Chapter 3). This dissertation is guided by both the proximate determinants of health framework as described in Chapter 2 and the socio-ecological theory adapted from the Bronfenbrenner Model as presented in Chapter 3. This dissertation adds to both the field of HIV and education research by synthesizing the literature that currently exists, illustrating the influence of education on known determinants of HIV acquisition, and concluding with actionable research and policy recommendations to continue progress toward educational attainment and improving health outcomes. (Abstract shortened by ProQuest)

Indexing (document details)
Advisor: Santelli, John
Commitee: Hoffman, Susie, Landers, Cassie, Stark, Lindsay
School: Columbia University
Department: Population and Family Health
School Location: United States -- New York
Source: DAI-B 80/09(E), Dissertation Abstracts International
Subjects: Behavioral psychology, Public health, Health education
Keywords: AIDS, Education, Uganda, Young adults
Publication Number: 13861055
ISBN: 978-1-392-13916-5
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