The Impact of the Quality of Sexual Education on HIV/AIDS in Zambia: Evidence from a Natural Experiment

Abstract Background:This paper focuses on how sexual education quality is associated with HIV-related knowledge, stigma and risky sexual behaviour among Zambians. The implementation of the Comprehensive Sexuality Education programme since 2014, with sequential in-service teacher training provides a natural experiment for testing the hypothesis that quality of sexual education, not quantity only, is positively associated with HIV knowledge, and negatively associated with risky sexual behaviours and stigma. Methods: Data are drawn from the 2016 Zambian Population-Based HIV Impact Assessment survey, which sampled 24,663 individuals aged 15-59 years old nationwide. Province fixed-effects double difference model is used to test our hypothesis. Results: We found that sexual education with well-trained teachers reduced the number of HIV-related stigma by 0.13 points, while as expected it was associated with a greater number of correct HIV-related knowledge (0.29 points). No significant association was found between quality of sex education and risky sexual behaviours. Conclusion: These results point to the importance of investing in high quality sexual education to combat the HIV-AIDS progression.