Secondary Schooling and HIV Risk

Increasing the years of secondary school may lower the risk of contracting HIV, particularly for girls, and could be a cost-effective approach to HIV prevention, report a team of investigators from the United States and Botswana (De Neve J-W et al.Lancet Glob Health. doi:10.1016/S2214-109X(15)00087-X [published online June 29, 2015]).

The study exploited a policy reform of the grade structure of secondary education in Botswana that was implemented in January 1996 that shifted the 10th year of education from senior secondary to junior secondary school. Completion of junior secondary school is a common exit point for many students, and this change made 10th grade more accessible and increased the average years of schooling by nearly 1 year.

In this study, the researchers compared birth cohorts exposed to the reform with those who were not to estimate the causal effect of years of schooling on the probability of acquiring HIV. They used data for HIV biomarkers and demographics from 2 nationally representative household surveys carried out in 2004 and 2008 among 7018 men and women.

They found that each additional year of secondary school resulted in an 8% absolute reduction (from 25.5% to 17.4%) in the cumulative risk of HIV infection. The effects were even larger in women, who had an 11.6% absolute reduction in cumulative risk of HIV infection. The authors note limitations of their study, such as the assumption that no cohort-specific effects other than the educational reform could account for the change in HIV risk.

 read more at JAMA