Girls’ education and HIV risk: Evidence from Uganda

Girls’ enrollment in secondary education significantly increased girls’ likelihood of abstaining from sex, and thereby decreased the prevalence of HIV/AIDS for girls in Uganda.


The HIV/AIDS epidemic has been a persistent problem in sub-Saharan Africa. A notable exception is Uganda, which has widely been acknowledged as a place where HIV/AIDS has been successfully curtailed.  HIV prevalence in Uganda has fallen from 15 percent in 1990 to 5 percent in 2007. This drop was particularly significant in the early 1990s (1990 to 1995), when the HIV prevalence in pregnant women dropped from 30 to 15 percent. This change was especially notable in women under the age of 25.

Previous research suggests that many factors may have contributed to this outcome. However, there is evidence that education has a notable effect in decreasing the rates of school dropouts, STIs, and teen pregnancy and may have also played a role in Uganda’s reduction in HIV prevalence. In the early 1990s, a significant increase in girls’ enrollment in secondary education coincided with the significant decrease in HIV prevalence in Uganda. This increase in school enrollment was attributable to an affirmative action policy enacted in 1990 that gave women an advantage over men in university applications.

Although many factors likely led to the observed reduction in Uganda’s HIV/AIDS epidemic, researchers in this study, through an analysis of the antenatal clinic (ANC) and the Demographic Health Surveys (DHS) data, investigated how increased educational enrollment (in the aftermath of the 1990 affirmative action policy) contributed to the declining trend of HIV prevalence in Uganda.


Girls’ enrollment in secondary education significantly increased girls’ likelihood of abstaining from sex, which helped curtail the HIV/AIDS crisis in the early 1990s in Uganda. Enrollment in secondary education among girls is correlated with increased knowledge about HIV.

  • Using a statistical analysis that controlled for a person’s proximity to a university, birth year, and gender, researchers found that Uganda’s affirmative action policy was effective in increasing the percentage of women enrolling in secondary education in this time period.
    • Overall, the percentage of young women between the age of 15 and 24 who had never been married and who attended secondary schooling increased from 24 to 36 percent
  • The affirmative action policy contributed to a 2 to 6 percentage point reduction in HIV prevalence among young Ugandan women in the early 1990s. Since the overall reduction in HIV prevalence was 13 percentage points, the affirmative action policy accounted for between one-sixth and one-half of the overall reduction in HIV prevalence, assuming that most of the lifetime risk for acquiring HIV occurs in the premarital period.
  • By 1995, 85 percent of young women between age 15 and 24 with a secondary education knew that HIV could be sexually transmitted, whereas only 25 percent of young women of the same age group without a secondary education had this knowledge.
  • Girls’ enrollment in secondary education significantly increased girls’ likelihood of abstaining from sex. A girl enrolled in secondary education is 80 to 90 percentage points likely to abstain from sex than a girl who is not.

In this study, researchers investigated the relationship between secondary education and abstinence from sex within the context of the HIV/AIDS crisis in the early 1990s in Uganda. The study used two primary sources of data: data from urban antenatal clinics (ANC) in Uganda and data from the Demographic and Health Surveys (DHS) in Uganda throughout the early 1990s. The ANC dataset was used to assess the incidence of HIV/AIDS among the population, and the DHS dataset was used to assess sexually risky behavior. In general, the major criticism about studies using epidemiological modeling to draw statistical conclusions is that the quality of the epidemiological data is not high during this time period (early 1990s). The ANC data was chosen for this study because it is the most complete data on HIV status over the time period of interest. Most pregnant women attended these clinics which often provided standard HIV screening. The ANC dataset has been criticized for not being representative of the general population, including for non-pregnant women. The study researchers still used this dataset because, when comparing its HIV rates to those from Uganda in 1989, they found that the rates were comparable, and therefore the ANC data was still relevant for this investigation. The data segments that were used as control groups were men of the same age group (15 to 24 years old) and 30-year-old women, which showed the rate of enrollment in secondary education in comparison. There was concern that a person’s distance from a university would skew the data (since some hypothesized that many schools had been established by missionaries, and therefore those more likely to attend university due to proximity would also be more likely to be religious and therefore abstain from sex). Thus, in their econometric analysis of the relationship between secondary education and abstinence from sex, these researchers controlled for location-specific factors.

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