Educating young women has many health and economic benefits, but does continued schooling reduce a young woman’s risk of HIV infection? A study conducted in Botswana suggests that it does. The results, published in The Lancet Global Health, showed that secondary school students who stayed in school for an extra year had an 8 percentage point lower risk of HIV infection about a decade later, from 25% to about 17% infected. The effects were especially strong among young women, with an additional year of secondary schooling reducing infection risk by 12 percentage points.
Botswana has one of the highest rates of HIV prevalence in the world, with over 20% of adults aged 15–49 infected. Though it’s difficult to isolate the effect of formal education on the risk of becoming infected with HIV, the study used a school policy reform implemented in 1996 as a “natural experiment” to determine the impact of increased years of secondary schooling on infection risk. The reform provided free grade ten education as part of junior—rather than senior—secondary school.
The policy change presented a unique opportunity to estimate the causal effect of length of schooling on risk of HIV infection by comparing birth cohorts exposed to the reform versus those unexposed. The researchers used statistical techniques commonly used in economics and political science to analyze natural experiments. The authors investigated the causal effect of an additional year of schooling on HIV status in 7018 men and women.
“Information about prevention methods and reasoning skills gained in school may play a preventative role against HIV, enabling people with education to adopt healthy strategies to avoid infection,” said Dr. Jan-Walter De Neve, first author on the study and a doctoral student at the Harvard T.H. Chan School of Public Health. “Secondary schooling may be particularly effective in reducing HIV risk by targeting a critical period of growth in adolescence.”
Title image: © Trapped in School CC- BY 2014 Francesco Volpi