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Increasing secondary education reduces HIV infection rates
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A Botswanan policy change extending the duration of secondary schooling may have led to a decrease in HIV infection, according to recently published data.
“These findings confirm what has been fiercely debated for more than 2 decades — that secondary schooling is an important structural determinant of HIV infection and that this relation is causal,” Jan-Walter De Neve, a doctoral student at Harvard T.H. Chan School of Public Health, said in a press release.
De Neve and colleagues examined data from the Botswana AIDS Impact surveys (BAIS) II and III, performed in 2004 and 2008, respectively. To measure the effect of a 1996 policy reform extending junior secondary schooling to a 10th year, included respondents of the nationally representative, cross-sectional HIV biomarker collection surveys were aged 18 years or older and were not born earlier than 1975. Individuals born in 1981 or later were classified as “exposed” to the new policy, and those earlier “unexposed.” HIV infection rates were analyzed for men and women with adjustments for age, and the cost-effectiveness of secondary schooling compared with other HIV prevention methods also was calculated.
Valid data from 3,965 female and 3,053 male participants were included in the analysis. After reform implementation, there was a 0.792 year increase in the average years of completed schooling among respondents (P < .0001).
Women and men exposed to the reform were 7.4% less likely to have HIV than those unexposed (P = .017), men were 5% less likely (P = .052), and men and women together were 6.4% less likely (P = .002). Each additional year of school completion caused by the policy change resulted in an 8.1% reduction of HIV infection risk (P = .008). The researchers estimated the cost of each averted infection to be $27,753, which was considered by WHO benchmarks to be cost-effective for the country.
“Information about prevention methods and reasoning skills gained in school may play a preventive role against HIV, enabling people with education to adopt healthy strategies to avoid infection,” De Neve said in a press release. “Additionally, education may expand economic opportunities and reduce women’s participation in higher risk transactional sexual relationships. Secondary schooling may be particularly effective in reducing HIV risk by targeting a critical period of growth in adolescence.” – by Dave Muoio
Disclosure: The researchers report no relevant financial disclosures.
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