Abstract
We examine the relationship between school attendance and HIV incidence among young women in South Africa. Our aim is to distinguish a causal effect from correlation. Towards this end, we apply three methods to population-based longitudinal data for 2005–2012 in KwaZulu-Natal. After establishing a negative association, we first use a method that assesses the influence of omitted variables. We then estimate models with exclusion restrictions to remove endogeneity bias, and finally we estimate models that control for unobserved factors that remain constant over time. All the three methods have strengths and weaknesses, but none of them suggests a causal effect. Thus, interventions that increase school attendance in KwaZulu-Natal would probably not mechanically reduce HIV risk for young women. Although the impact of school attendance could vary depending on context, unobserved variables are likely to be an important reason for the common finding of a negative association between school attendance and HIV incidence in the literature.
Highlights
HIV infections are decreasing in most countries, about 800 000 individuals in Eastern and Southern Africa became infected in 2016
Large investments have been devoted towards this end. It is a key component of the DREAMS program, a USD 385 million partnership that aims to reduce HIV infections among adolescent girls and young women in South Africa and nine other sub-Saharan African countries during the few years [5]
In this paper we focus on the impact of attending school on HIV incidence
Summary
HIV infections are decreasing in most countries, about 800 000 individuals in Eastern and Southern Africa became infected in 2016. In South Africa, there were 270 000 new HIV infections, increasing the number of infected to 7.1 million people [1]. Keeping girls in school is considered one of the most powerful prevention methods for reducing HIV among adolescent girls across Africa [2, 3, 4]. Large investments have been devoted towards this end It is a key component of the DREAMS program, a USD 385 million partnership that aims to reduce HIV infections among adolescent girls and young women in South Africa and nine other sub-Saharan African countries during the few years [5]
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