Background There is evidence that attendance at school is protective against HIV among young people in South Africa. Further work is required to investigate the effect of education on the life-time risk of HIV in sub-Saharan Africa. In this paper, we have examined the association between education and HIV infection/sexual risk behaviour among men and women of different ages in Zimbabwe.
Methods The effects of education level (none or primary only; secondary or higher) on prevalent HIV infection and sexual risk behaviours among young people of school age (15–21 years) and older adults (22–54 years) were investigated using data from four rounds of an open cohort study collected between 1999 and 2008 in Manicaland, Eastern Zimbabwe. Multivariate regression models were used to investigate the independent effects of education, marriage and wealth.
Results School-aged men, interviewed in 1999/2000, with secondary or higher education had significantly reduced risk of HIV infection compared to those with none or primary education only (adjusted OR=0.35; p=0.011). For older men, the effect of education level was not significantly associated with HIV risk (adjusted OR=1.17; p=0.125). For those interviewed in 2006/2008, education level was not found to be independently associated with HIV infection among school-aged or older men. At both time points, marital status and living in a town were independent risk factors for HIV among older men. Among women interviewed in 1999/2000, adjusted models indicate that a higher level of education had a significant protective effect for school-aged (adjusted OR=0.64; p=0.023) and older (adjusted OR=0.80; p=0.017) women. For those interviewed in 2006/2008, a higher level of education level was protective among school-aged (adjusted OR=0.56; p=0.040) but not older (adjusted OR=0.99; p=0.940) women. Marital status was an independent risk factors for HIV infection fort women of all ages.
Conclusions There is evidence that secondary or higher education is protective against HIV infection among school-aged people in Zimbabwe, particularly women. Among older men, education does not appear to be protective against HIV. In 1999/2000, secondary or higher education was protective against HIV among older women. However, in 2006/2008, this protective effect was reduced. Further work to calculate the lifetime cumulative risk of HIV infection by education level, in this population, will be conducted.
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