To educate a woman and to educate a man: Gender-specific sexual behavior and human immunodeficiency virus responses to an education reform in Botswana

Health Econ. 2021 Mar;30(3):642-658. doi: 10.1002/hec.4212. Epub 2020 Dec 28.

Abstract

This study analyses mechanisms that link education to human immunodeficiency virus (HIV) with a focus on gender differences, using data from four nationally representative surveys in Botswana. To estimate the causal effect, an exogenous 1-year increase of junior secondary school is used. The key finding is that women and men responded differently to the reform. Among women, it led to delayed sexual debut and reduced time between first sex and marriage by up to a year. Among men, risky sex, measured by the likelihood of concurrent sexual partnerships and paying for sex, increased. The increase in risky sex among men is likely to be due to the education reform's positive impact on income. The reform reduced the likelihood of HIV infection sharply among women, especially among relatively young women age 18-24. The impact on men's likelihood of HIV infection is uncertain.

Keywords: HIV; education; gender; sexual behavior.

MeSH terms

  • Adolescent
  • Adult
  • Botswana / epidemiology
  • Educational Status
  • Female
  • HIV
  • HIV Infections* / epidemiology
  • Humans
  • Male
  • Sexual Behavior
  • Young Adult