Education, HIV Status, and Risky Sexual Behavior: How Much Does the Stage of the HIV Epidemic Matter?

We study the relationship between education and individual HIV status using nationally representative data (Demographic and Health Surveys, DHS) for 18 countries in Sub- Saharan Africa (SSA). Because the diffusion of knowledge on HIV preventionhence, actual change in sexual behaviormay differ across education groups, we explicitly explore the possibility of a dynamic relationship between education and the probability of being infected with HIV over aggregate stages of the HIV epidemic. Our contribution is twofold. First, we construct an innovative algorithm that positions, for any set of countries, the country-specific evolution of the HIV epidemic in a unified frameworka normalized epidemiological spaceto define stages of the HIV epidemic in a comparable manner across SSA countries. Second, using this framework, we exploit epidemiological stage variation across DHS country observations and find that the relationship between education and individual HIV status is dynamic and significantly evolves with the course of the epidemic. Specifically, we show that the education gradient of HIV displays a large U-shaped (positive-zero-positive) pattern over the aggregate stages of the HIV epidemic.