Are people who are less educated more likely to become HIV infected than people with a higher level of education? And what can be done to help those most at risk? Researchers from the London School of Hygiene and Tropical Medicine looked for possible links between AIDS and education in developing countries.

In the four areas of Africa surveyed it was more educated individuals who were at greater risk of being infected. However, this pattern is now changing. The burden of new infections is falling increasingly on less educated groups. In Thailand, where AIDS emerged later, people with more schooling were less likely to be HIV positive.

So how might education and the AIDS virus be linked? People with a higher level of education and more disposable income may behave in a way that increases the risk of contracting HIV, such as engaging with commercial sex workers and having wider sexual networks. Educated women may also suffer as a result of their husbands’ behaviour. However, attending school provides access to health services and health education programmes. It may also make people more able to understand and act on the health information they receive.

The research suggests that at early stages of the HIV epidemic in Africa, HIV infection was linked to the higher social groups and people with greater mobility, providing opportunities for casual sex. However, as the epidemic spreads, and as prevention messages become more widespread, this link may be disappearing.

The research also found that:

• Until the mid-1990s there was a greater risk of HIV infection among the more educated, according to large surveys carried out in four areas of Africa.
• The link was stronger in rural areas and amongst older age groups but it applied equally to men and women.
• In Thailand more time at school provided army conscripts with greater protection from HIV.
• The number of new HIV infections in Uganda, Zambia and Thailand is falling over time, but falling fastest among the most educated groups.
• In Tanzania the link between education and HIV has remained steady over a period of time.

The study suggests that:

• The only way to control the spread of HIV is through preventing new infections.
• As there is no vaccine or widely available treatment for the AIDS virus, changing people's behaviour must be central to controlling the epidemic.
• More work must be done to improve and expand access to HIV prevention, and must be sure to include less educated groups.
• General education levels should be raised.

Source(s):
‘Education attainment and HIV-1 infection in developing countries: a systematic review’, Tropical Medicine and International Health, Vol 7 (6): 489-498, by J.R. Hargreaves & J.R. Glynn, 2002
HINARI subscribers can access the full-text article here. Full document.
'Declining HIV prevalence and risk behaviours in Zambia:evidence from surveillance and population based surveys', AIDS 15: 907-916, by K. Fylkesnes, R.M. Musonda, M. Sichone, Z. Ndhlovu, F. Tembo and M. Monze, 2001

Funded by: UNAIDS

id21 Research Highlight: 14 January 2003

Further Information:
Judith Glynn
Infectious Disease Epidemiology Unit
London School of Hygiene and Tropical Medicine
Keppel Street
London
WC1E 7HT
UK

Contact the contributor: judith.glynn@lshtm.ac.uk

London School of Hygiene and Tropical Medicine, UK

Other related links:
See id21's collection of links relevant to HIV/AIDS.