What Works for Women and Girls

oth sexes among urban young people in men and in women. A similar pattern wasobserved in rural young men but was less prominent and not statistically significant inrural women. In age 25–49 years, higher educated urban men had reduced risk in 2003but this was less prominent in women. The findings suggested a shift in the associationbetween educational attainment and HIV infection between 1995 and 2003. The mostconvincing sign was the risk reduction among more educated younger groups wheremost infections can be assumed to be recent. The changes in older groups are probablylargely influenced by differential mortality rates. The stable risk among groups withlower education might also indicate limitations in past preventive efforts (Michelo et al.,2006). (Gray III) (education, Zambia)Cross sectional data from a population-based survey with 9,843 adults (80% of thoseeligible) including 2,268 young women large-scale, conducted between 1998 and 2000in rural Zimbabwe found that young women’s chances of having avoided HIV werestrongly associated with experience of secondary education. “Young women with higherlevels of school education...had better knowledge about HIV...(and) young women withgreater knowledge about HIV” were more likely not to have started sex and to haveavoided HIV (Gregson et al., 2004, p. 2126). Greater education was positively associatedwith self-efficacy in both married and unmarried young women (Gregson et al., 2004).(Gray V) (education, self-perception, Zimbabwe)DHS surveys from 11 countries found that women with some schooling were nearlyfive times as likely as uneducated women to have used a condom the last time they hadsexual intercourse (Global Campaign for Education, 2004). Literate women are threetimes more likely than illiterate women to know that a healthy-looking person can beHIV-positive and four times more likely to know preventive behaviors (Vanandemoorteleand Delamonica, 2000 cited in Global Campaign for Education, 2004). While universalprimary education is not a substitute for HIV/AIDS treatment and prevention, youngpeople with little or no education may 2.2 times more likely to become HIV-positiveas those who have completed primary education (De Walque, 2004 cited in GlobalCampaign for Education, 2004). Even controlling for income, education’s impact onHIV/AIDS is robust. In the five years before the publication, better-educated youngpeople have increased condom use and reduced the number of casual partners at amuch steeper rate than those with little or no education (Hargreaves and Glynn, 2002;World Bank, 2002 cited in Global Campaign for Education, 2004). (Gray V) (education,condoms, protective behavior)2. Abolishing school fees can enable girls to attend (or stay in) school.A 2009 World Bank and UNICEF study evaluated the impact of primary school feeabolition in five African countries. Ethiopia abolished primary school fees in 1994,Ghana in 1995, Kenya in 2003, Malawi in 1994, and Mozambique began implementationin 2004. Fees were abolished in all countries for grades 1 through 7, with several326 CHAPTER 11 STRENGTHENING THE ENABLING ENVIRONMENT