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AIDS Care
Psychological and Socio-medical Aspects of AIDS/HIV
Volume 24, 2012 - Issue 5
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ORIGINAL ARTICLES

The impact of education on sexual behavior in sub-Saharan Africa: A review of the evidence

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Pages 562-576 | Received 24 Dec 2010, Accepted 28 Sep 2011, Published online: 07 Dec 2011
 

Abstract

Many studies have attempted to determine the relationship between education and HIV status. However, a complete and causal understanding of this relationship requires analysis of its mediating pathways, focusing on sexual behaviors. We developed a series of hypotheses based on the differential effect of educational attainment on three sexual behaviors. We tested our predictions in a systematic literature review including 65 articles reporting associations between three specific sexual behaviors–sexual initiation, number of partners, and condom use–and educational attainment or school enrollment in sub-Saharan Africa. The patterns of associations varied by behavior. The findings for condom use were particularly convergent; none of the 44 studies using educational attainment as a predictor reviewed found that more educated people were significantly less likely to use condoms. Findings for sexual initiation and number of partners were more complex. The contrast between findings for condom use on the one hand and sexual initiation and number of partners on the other supports predictions based on our theoretical framework.

Notes

1. In cases where studies presented differing effects for multiple countries or groups (i.e., rural/urban or religious groups), the study was counted once for each relevant effect category – positive, negative, and nonsignificant. Thus, in some cases the total number of studies is smaller than the sum of the three effect categories.

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