What Works for Women and Girls

likely than illiterate women to know that a healthy-looking person can be HIV-positive and fourtimes more likely to know preventive behaviors (Vanandemoortele and Delamonica, 2000cited in Global Campaign for Education, 2004). While universal primary education is nota substitute for HIV/AIDS treatment and prevention, young people with little or no educationmay 2.2 times more likely to become HIV-positive as those who have completed primaryeducation (De Walque, 2004 cited in Global Campaign for Education, 2004). Even controllingfor income, education’s impact on HIV/AIDS is robust. In the five years before the publication,better-educated young people have increased condom use and reduced the number of casualpartners at a much steeper rate than those with little or no education (Hargreaves and Glynn,2002; World Bank, 2002 cited in Global Campaign for Education, 2004).Yet girls face barriers to staying in school. A study of primary school in Uganda in 2001found that 51 percent of girls dropped out of primary school due to money needed for schoolfunds, uniforms, textbooks and supplies, among other items, including uniforms and shoes.Some girls receive pressure from their parents to marry (Kasente, 2003). One study found thatsince 2003 when school fees were abolished in Kenya, girls in schools with free uniforms hada 10 percent decrease in childbearing and a 12 percent decrease in teen marriage (Duflo et al.,2007). Furthermore, lack of sanitary facilities means that girls and female teachers cannotattend school during menstruation” (Adams et al. 2009). An estimated 1 in 10 African girlsof school age do not attend school during menstruation or drop out at puberty due to lack ofappropriate sanitation facilities in schools (UNICEF, 2005). Further interventions are neededto eliminate these barriers and enable girls to stay in school, for example “school fee abolitionstrategies to be embedded within country-wide poverty alleviation and growth strategies”(World Bank and UNICEF, 2009: 11), or improving sanitary facilities so girls can attend schoolwhen they are menstruating (Adams et al., 2009).What Works—Strengthening the Enabling Environment: Advancing Education1. Increasing educational attainment can help reduce HIV risk among girls.2. Abolishing school fees enables girls to attend (or stay in) school.3. Providing life skills-based education can complement formal education in buildingknowledge and skills to prevent HIV.EVIDENCE1. Increasing educational attainment can help reduce HIV risk among girls.A systematic review of published peer-reviewed articles explored the time trends in theassociation between educational attainment and risk of HIV infection in sub-SaharanWHAT WORKS FOR WOMEN AND GIRLS323