An additional year of schooling does not significantly reduce the risk of HIV infection among adults in sub-Saharan Africa, a major study across 23 countries has found, raising questions about the assumption that expanding education alone can help curb the epidemic.
Published in BMJ Open, the study, however, found that more schooling was associated with a greater likelihood of HIV testing and improvements in selected sexual health behaviours.
The research was conducted by Justin Parkhurst, Olivia Klaassen, Pepita Barlow and Ranjeeta Thomas.
Titled “Effects of an increase in schooling on HIV infection and behavioural risk: a multicountry instrumental variable analysis of 23 sub-Saharan African countries”, the study analysed data collected between 2003 and 2019 from 191,128 adults aged 18 to 49 across the 23 countries.
ALSO READ: 20-year-old female co-pilot killed in Florida Learjet crash identified
The researchers examined the effects of education reforms, including free schooling, compulsory education and policies expanding access to primary and secondary education. They compared generations likely to have benefited from the reforms with older groups less likely to have been affected.
The reforms increased schooling by an average of 0.45 years. However, an additional year of education was associated with only a 0.5 percentage-point reduction in HIV positivity, a finding that was not statistically significant.
The study found that an additional year of schooling was associated with a 4.6 percentage-point increase in the likelihood of having ever tested for HIV. However, this finding was statistically significant only at the 10 per cent level, below the conventional five per cent threshold.
The researchers also identified differences among population groups.
Among women, additional schooling was associated with delaying sexual debut by approximately four months. Among men, it was linked to a 5.5 percentage-point increase in condom use.
Urban residents recorded a three percentage-point increase in condom use, while rural residents showed a five percentage-point increase in the likelihood of having ever tested for HIV.
However, the study found no significant overall improvement in comprehensive HIV knowledge or combined behavioural outcomes.
The findings suggest that education alone may be insufficient to reduce HIV transmission, particularly where people continue to face poverty, gender inequality, stigma and limited access to sexual health services.
For Nigeria and other African countries, the study reinforces the need to complement education policies with accessible HIV testing, condom distribution, antiretroviral treatment, biomedical prevention and effective sexual health education.
The researchers cautioned that the findings do not mean education is ineffective. Rather, they suggest that its influence on HIV infection is more complex than simply increasing the number of years people spend in school.
They acknowledged limitations, including incomplete information on the implementation of some education reforms and the possibility that other social or policy changes influenced the results.
They also noted that the findings mainly reflect the experiences of people whose schooling was affected by the reforms and may not apply equally to everyone.
The study’s central message is that education remains important, but it should be combined with accessible health services and targeted interventions addressing the social conditions that increase people’s vulnerability to HIV.
WATCH TOP VIDEOS FROM NIGERIAN TRIBUNE TV