Advancing Education
Increasing the access of girls to education is critical to combating the AIDS pandemic. Education of girls is associated with delayed marriage and childbearing, lower fertility, healthier babies, and increased earning potential. Analysis by the Global Campaign for Education estimates that seven million HIV infections in young people could be averted in a decade, if all children completed primary school (Global Campaign for Education, 2004, cited in UNAIDS et al., 2004). The 2009 report of the Millennium Development Goals (UN, 2009) shows that in the developing world, enrollment coverage was 88 percent in 2007, up from 83 percent in 2000, but still not on track to reach the MDG Goal 2 of achieving universal primary education. Furthermore, in 2007, in the 171 countries with data, only 53 had achieved the target of gender parity in education. An estimated “72 million children worldwide were denied the right to education in 2007. Almost half of these children live in sub-Saharan Africa, followed by Southern Asia, home to 18 million out-of-school children” (UN, 2009) It is estimated that half or more of those children might never have any schooling.
Education: The “Window of Hope” in HIV Prevention
The effectiveness of education as an HIV prevention strategy, which the World Bank calls the “window of hope,” rests upon two key components: (1) greater access to schooling and (2) using schools as a natural place to reach young people with AIDS education and life skills training – practical tools that help them stay safe (World Bank, 2002). “Data compared across countries and regions and disaggregated by education levels show that young women and men with higher levels of education are more likely to have increased knowledge about HIV/AIDS, a better understanding of ways to avoid infection, and an increased likelihood of changing behaviour that puts them at risk of contracting the disease. Thus, it is clear that ensuring quality education for all children is one of the best ways to protect both the rights and the lives of young people threatened by HIV/AIDS” (UNICEF, 2004a). Comprehensive sex education, covered in Chapter 5. Prevention for Young People, is also an important component of HIV prevention planning.
DHS surveys from 11 countries found that women with some schooling were nearly five times as likely as uneducated women to have used a condom the last time they had sexual intercourse (Global Campaign for Education, 2004). Literate women are three times more likely than illiterate women to know that a healthy-looking person can be HIV-positive and four times more likely to know preventive behaviors (Vanandemoortele and Delamonica, 2000 cited in Global Campaign for Education, 2004). While universal primary education is not a substitute for HIV/AIDS treatment and prevention, young people with little or no education may 2.2 times more likely to become HIV-positive as those who have completed primary education (De Walque, 2004 cited in Global Campaign for Education, 2004). Even controlling for income, education’s impact on HIV/AIDS is robust. In the five years before the publication, better-educated young people have increased condom use and reduced the number of casual partners at a much steeper rate than those with little or no education (Hargreaves and Glynn, 2002; World Bank, 2002 cited in Global Campaign for Education, 2004).
Yet girls face barriers to staying in school. A study of primary school in Uganda in 2001 found that 51 percent of girls dropped out of primary school due to money needed for school funds, uniforms, textbooks and supplies, among other items, including uniforms and shoes. Some girls receive pressure from their parents to marry (Kasente, 2003). One study found that since 2003 when school fees were abolished in Kenya, girls in schools with free uniforms had a 10 percent decrease in childbearing and a 12 percent decrease in teen marriage (Duflo et al., 2007). Furthermore, lack of sanitary facilities means that girls and female teachers cannot attend school during menstruation” (Adams et al. 2009). An estimated 1 in 10 African girls of school age do not attend school during menstruation or drop out at puberty due to lack of appropriate sanitation facilities in schools (UNICEF, 2005). Further interventions are needed to eliminate these barriers and enable girls to stay in school, for example “school fee abolition strategies to be embedded within country-wide poverty alleviation and growth strategies” (World Bank and UNICEF, 2009: 11), or improving sanitary facilities so girls can attend school when they are menstruating (Adams et al., 2009).