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Abstract
The institution of marriage plays some role in determining one’s risk of exposure to HIV. Since
the transmission of HIV in the population is mainly through sexual activity, avoiding infection depends
on risk-avoiding behavior. Consistently, empirical results show that excess mortality is concentrated in
not-yet married adults aged 20-39 among both men and women. Therefore, the choice of when and who
to marry appears to be related to risk of exposure.
The objective of this paper is to determine the effect that schooling has on HIV/AIDS excess
mortality, using panel data from South Africa. This paper tests the hypothesis that schooling affects when
and who one marries and thus impacts the risk of mortality from HIV/AIDS. The effect could be negative
or positive. On the one hand, since educated agents have incentives to secure returns to their human
capital in the future, more education implies earlier marriage, given that the marriage institution
effectively decreases the HIV-related mortality risk. On the other hand, education increases the
opportunity costs of marriage especially for women, who need to increase their time spent in the
household. Thus, schooling may increase mortality risks due to the increased risk of HIV infection.
The empirical analysis of this research uses an identification strategy for mortality shock based on
the following observation: before 1980, fertility decisions and mortality incidences in South Africa were
not related to the coming AIDS epidemic in the mid 1990s. This condition enables us to argue that
cohort-specific factors among those who were ages 20 or above in the mid 1990s (when the first round of
our data was collected) are not correlated with the AIDS epidemic. Therefore, after controlling the non-
AIDS mortality rate, the cohort-specific mortality changes in the period of 1998-2004 can be mainly
attributed to the AIDS epidemic, and are treated as exogenous shocks to the adult population. In the
analysis to estimate the cohort-specific schooling effects in the mortality equation, we also control for
household-level fixed unobservables and age (cohort)-specific unobservables in order to base our
statistical inferences on within-household and within-age group variations in mortality incidence and
schooling.
Results show that schooling increases excess mortality among women, but not among men. This
gender difference is consistent with their marriage behavior. The probability of marriage decreases
among educated women if the direct cost of marriage increases (that is, if Lobola—a gift from the groom
to the bride’s family—payment is the norm in the community). For men the probability of marriage is
lower than for women. In contrast to women, educated men are more likely to get married when the
direct cost of marriage increases. In sum, schooling increases the opportunity cost of marriage for
women, which delays marriage and increases their mortality risks in high HIV-prevalence societies, but
has the opposite effect on men.
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Our analysis demonstrated the need to integrate our understandings of the marriage market, the
labor market, schooling investments, and youth behavior to identify the determinants of AIDS-related
excess mortality. The marriage institution potentially protects the youth from excess mortality, but the
interactions between marriage and labor markets complicate the role of schooling in determining excess
mortality. This finding is also policy relevant as we need to pay special attention to the differentiated
mortality risks between women and men to effectively reduce gender-specific AIDS-related excess
mortality.