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Why schooling is vital in HIV prevention

IT WAS during the commemoration of World AIDS Day last year that a traditional leader, again, raised the issue of school drop-outs leading to an increase in HIV infections.
Senior Chief Kanongesha of the Lunda people in Mwinilunga district of the North-Western Province was certainly on solid ground.
His argument was that pupils who dropped-out of school and are not streamlined in the education mainstream are likely to engage in illicit behaviours of excessive drinking beer, drug abuse and prostitution.
The solution, as he sees it, is to co-opt pupils, particularly those that have failed exams in the education mainstream, because then, they would be kept busy with their studies.
Senior Chief Kanongesha’s argument has been supported by findings on the ground.
Titled “Cash to Stay in School Didn’t Reduce HIV Incidence, but attendance Protects Young Women”, the report produced by researchers in collaboration with, a website which summarises HIV and AIDS news for a layman audience, found that dropping out of school, or poor school attendance, was associated with a significantly higher rate of HIV incidence in young women.
The findings are said to have confirmed observations in several African countries which show that education has a protective effect against HIV infection both during the school years and afterwards for young women.
There were two studies involved; one designed to evaluate the effect of conditional cash transfers on HIV incidence in young women while the other one reported on the efficacy of a school-based educational intervention and cash incentives for achieving behavioural and educational outcomes.
The overall report found that apart from the general economic and social benefits of education for young women, education has been associated with a range of outcomes that could reduce the risk of HIV infection.
For instance, better-educated young women are more likely to delay their sexual debut, to use condoms more frequently, to delay marriage and childbearing and to have better earning potential, according to studies in a range of countries in southern and eastern Africa.
South African researcher Matthew Jukes has argued that education protects against HIV by increasing understanding of messages about HIV and improving the ability of young people – especially girls – to act on those messages.
“However, economic status probably contributes to the effect too – in complex ways. A study in Malawi found that providing cash transfers to the households of young women reduced HIV prevalence by 60 percent – but making the payments conditional on school attendance made no difference to the reduction in HIV infection,” according to the findings.
“The researchers found that girls receiving payments had sex with partners closer to their own age, and were less likely to have exchanged sex for money. The additional income may have made the girls less dependent on using sex as a way to get essential resources.
“Remaining in school is a financial challenge for many young women and their families. Costs of uniforms, books and transport may be difficult to meet, and household pressure to earn money may cause young people to drop out of school.
“Young women are more likely than young men to drop out of school to take on family caring responsibilities. Cash transfers to young women’s households have been proposed as a means of improving school attendance and educational outcomes, hopefully leading to a reduction in HIV incidence.”
However, school attendance in itself may also be protective against HIV because it places young women within a peer group of similarly-aged young men –and reduces opportunities for meeting older men.
The report says although there is conflicting evidence regarding the effects of older partner choice on a young woman’s risk of HIV infection, it is consistently the case that school-age males in Southern Africa have much lower HIV prevalence than older males – and much lower HIV prevalence than young women of the same age.
“Interventions which can reduce the very high incidence of HIV in young women in Southern Africa are urgently needed, and cash transfers are one means by which the protective effect of education might be promoted,” the report reads.
For Zambia, the need to keep children in school cannot be over-emphasised.
About 700,000 who are supposed to be in school are currently not enrolled in the country’s education system, according to Ministry of General Education permanent secretary Chishimba Nkosha.
“Latest survey reports indicate that there might be over 700,000 children of school going-age in the country who are not in school; a situation that is worrisome to us, especially that Zambia is a signatory to the United Nations convention on the right to education… It is for this reason that we call upon all the players in the education provision arena to join hands in the fight to enrol all children in schools,” Mr Nkosha said in a speech read for him by the ministry’s director of planning and information, Owen Mgemezulu, during the Zambia Open Community Schools (ZOCS) annual general meeting in Lusaka recently.
The scenario for girls is even worse.
According to Irish Aid, which supports a range of initiatives aimed at not only getting more girls into school but, importantly, helping them to complete their primary schooling and progress to secondary level, the pressures on girls to stay at home, especially if they come from a poor rural household, are many.
“In Zambia, for example, girls are far more likely to drop out of school. Twenty Seven percent of women in rural areas have no education compared to 18 percent of males. Pregnancy, early marriage and poverty are intrinsically linked and are the main challenges Zambian girls face in staying in school, particularly in rural areas,” an Irish Aid report on how it supports the education of girls in the country, reads.
Clearly, there is need for robust interventions to keep young people in school.