Setting Priorities for HIV/AIDS Interventions
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Setting Priorities for HIV/AIDS Interventions

A Cost–Benefit Approach

Robert J. Brent

HIV/AIDS is much too complex a phenomenon to be understood only by reference to common sense and ethical codes. This book presents the cost–benefit analysis (CBA) framework in a well-researched and accessible manner to ensure that the most important considerations are recognized and incorporated.
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Chapter 14: Education as a Factor Raising HIV Rates

Robert J. Brent


Here we examine the second of the paradoxes (income was the first) that was found in the Brent (2006) study of 31 SSA countries. This paradox involves the positive relation between female education and HIV rates. We will focus on just female education given that the majority of HIV cases in SSA involve women and gender-specific interventions would seem to be more likely to be important for the African HIV epidemic. As with the income paradox, there are many good reasons for thinking that the relationship between education and HIV should be negative. As the initial attempt to reconcile the paradox turns out to be incomplete, we will fill in the blanks to provide a second explanation that has more immediate policy significance. The story has a “happy ending” because of the joint interaction between income and education that was highlighted in the last chapter. REASONS FOR A POSITIVE EDUCATION/HIV LINK In the exploratory statistical study by Over (1998) of what determines HIV rates in 72 countries, he not only found the income effect discussed in the last chapter, he also found a particular education effect – that the greater the gap between female and male enrollment rates, the higher the country’s HIV rate. So if female enrollments could be made to rise relative to those of males, HIV rates can be reduced. A subsequent World Bank group study (World Bank, 2002, p. xvii), took the result for the male– female literacy gap seriously and gave it greater emphasis: “A general...

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