EDUCATIONAL OUTCOMES AND THEIR CORRELATES AMONG HIV INFECTED, HIV-EXPOSED UNINFECTED AND HIV UNEXPOSED UNINFECTED ADOLESCENTS IN KILIFI, KENYA

Abstract

Background: The United Nations AIDS report of 2019, projected that 37.9 million people were living with HIV with 1.7 million children having been infected by HIV globally(UNAIDS, 2019). Most of the children’s infections were vertical, from mother to child either during pregnancy in utero or delivery. With the increased availability and utilization of anti-retroviral drugs (ARVs) in Africa a significant number of children vertically infected with HIV are surviving to adolescence (Slogrove, Mahy, Armstrong, & Davies, 2017). Despite this, there is a dearth of systematic studies on the impact of HIV infection and exposure on school outcomes of adolescents in Africa. Aims: This study was specifically aimed at exploring how exposure to HIV affects Educational outcomes of the adolescents as a result of either exposure to it or infection. The main objective of this study was to describe educational outcomes among HIV infected and HIV exposed uninfected adolescents and examine correlates for educational/academic perfomance. Methods: The analysis described in this study drew data from the adolescents’ health outcomes study (AHOS) which involved a total of 558 (200 HIV infected, 158 HIV exposed uninfected and 200 HIV unexposed uninfected) adolescents aged 12-17 years. Birth certificates, and medical records were used to establish the real ages of the adolescents. An analytic cross-sectional study design was utilized. Each adolescent was interviewed once in the course of the research project within an eight months’ period. Additional data such grade in school, grade retention among other were assessed through parental report. A statistical computer package STATA was used to carry out this quantitative analysis. Descriptive statistics, univariate and multivariate analysis were carried to test study hypothesis. Further, path analysis was used to test a partial mediation model. vi Results: Access to educational services was reported by all adolescents irrespective of their HIV status. Perinatal HIV infection was associated with poor peer relationships (β= -0.18, p<0.001), poor school experience (β = -0.11, p < 0.011) and poor numeracy scores (β = -0.13, p < 0.001). Socio-economic status, assessed using an asset index, also greatly impacted on educational outcomes irrespective of HIV status (p<-0.004). A path model with an excellent fit of (RMSEA = 0.043, CFI 0.994, TLI 0.981, SRMR 0.029) indicated that HIV infection was associated with a host of challenges such as poor peer relationship, poor school experience and sense of school belonging which ended up affecting educational outcomes such as Numeracy for most adolescents. Conclusion HIV infected adolescents are at a high risk of poor educational outcomes. Evidence indicates that these poor outcomes are associated with a host of other psychosocial experience, which points to the need to comprehensive school interventions to enhance educational experiences for these adolescents and ensure optional scholastic achieve