Longer secondary schooling substantially reduces the risk of HIV infection—especially for girls—and could be a very cost-effective way to halt the spread of the virus, according to researchers from Harvard T.H. Chan School of Public Health. In a study in Botswana, researchers found that, for each additional year of secondary school, students lowered their risk of HIV infection by 8 percentage points about a decade later, from 25% to about 17% infected.

“These findings confirm what has been fiercely debated for more than two decades—that secondary schooling is an important structural determinant of HIV infection and that this relation is causal,” said Jan-Walter De Neve, first author of the study and a doctoral student in the Department of Global Health and Population.

The study appears online June 28, 2015 in The Lancet Global Health.

HIV continues to be a major global health challenge, with an estimated 2.1 million people becoming newly infected each year. Although some have claimed that formal education, particularly for girls, acts like a “social vaccine” to reduce the spread of HIV—because of hypothesized factors such as increased exposure to information about HIV and prevention methods, or improved cognitive skills to make complex decisions—studies to date have produced conflicting evidence for such an association.

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