title: The impact of school subsidies on HIV-related outcomes among adolescent female orphans.
abstract: OBJECTIVE
  We examine effects of school support as a structural HIV prevention intervention for adolescent female orphans in Zimbabwe after 5 years.
  
  
  METHODS
  Three hundred twenty-eight orphan adolescent girls were followed in a clustered randomized controlled trial from 2007 to 2010. The experimental group received school fees, uniforms, and school supplies and were assigned a school-based "helper." In 2011-2012, the control group received delayed partial treatment of school fees only. At the final data point in 2012, survey, HIV, and Herpes Simplex Virus Type 2 (HSV-2) biomarker data were collected from approximately 88% of the sample. Bivariate and multivariate analyses were conducted on end point outcomes, controlling for age, religious affiliation, and baseline socioeconomic status.
  
  
  RESULTS
  The two groups did not differ on HIV or HSV-2 biomarkers. The comprehensive 5-year intervention continued to reduce the likelihood of marriage, improve school retention, improve socioeconomic status (food security), and marginally maintain gains in quality of life, even after providing school fees to the control group.
  
  
  CONCLUSIONS
  Paying school fees and expenses resulted in significant improvements in life outcomes for orphan adolescent girls. Biological evidence of HIV infection prevention, however, was not observed. Our study adds to the growing body of research on school support as HIV prevention for girls in sub-Saharan Africa, but as yet, no clear picture of effectiveness has emerged.
authors.affiliation: The Pacific Institute for Research and Evaluation, Chapel Hill, North Carolina. Electronic address: Hallfors@pire.org.
authors.forename: Denise Dion
authors.initials: DD
authors.lastname: Hallfors
authors.affiliation: The Pacific Institute for Research and Evaluation, Chapel Hill, North Carolina.
authors.forename: Hyunsan
authors.initials: H
authors.lastname: Cho
authors.affiliation: Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Simbarashe
authors.initials: S
authors.lastname: Rusakaniko
authors.affiliation: Faculty of Education, Africa University, Mutare, Zimbabwe.
authors.forename: John
authors.initials: J
authors.lastname: Mapfumo
authors.affiliation: The Pacific Institute for Research and Evaluation, Chapel Hill, North Carolina.
authors.forename: Bonita
authors.initials: B
authors.lastname: Iritani
authors.affiliation: The Pacific Institute for Research and Evaluation, Chapel Hill, North Carolina.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: The Pacific Institute for Research and Evaluation, Chapel Hill, North Carolina.
authors.forename: Winnie
authors.initials: W
authors.lastname: Luseno
authors.affiliation: The Pacific Institute for Research and Evaluation, Beltsville, Maryland.
authors.forename: Ted
authors.initials: T
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D054540:Child, Orphaned / Q000706:statistics & numerical data*; D016000:Cluster Analysis; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D011788:Quality of Life; D012574:Schools / Q000191:economics*; D012959:Socioeconomic Factors; D015030:Zimbabwe / Q000453:epidemiology
keywords: HIV prevention; Orphan; Randomized Control Trial; Sub-Saharan Africa