Schools against AIDS: Secondary school enrollment and cross-national disparities in AIDS death rates

Although AIDS is a leading cause of death worldwide, the consequences of the pandemic are remarkably unequally distributed cross-nationally. This unequal global distribution of AIDS deaths should be of interest to sociologists because of the potential role of structural forces in accounting for these disparities. Yet, there has been relatively little sociological research on this topic. Using underutilized cross-national data on AIDS deaths, this study examines the macro-level sources of variation in AIDS death rates across 115 countries. The analysis focuses on secondary school enrollment as a key structural factor in reducing AIDS deaths. After controlling for the prevalence of HIV infection, secondary school enrollment has the second largest and most robust effect on AIDS death rates. Economic development also reduces AIDS death rates, but this effect is mediated by secondary school enrollment. Schooling matters partly because it reduces HIV prevalence, but education still continues to have a signifcant negative effect on AIDS deaths even after controlling for prevalence. The education effect is robust in a variety of sensitivity analyses. Ultimately, this study underscores the role of structural factors, particularly education, for understanding the AIDS crisis.