Among people with HIV there is a link between years spent in school and health outcomes after starting antiretroviral (ARV) treatment, aidsmap reports. Those with less schooling are less likely to achieve an undetectable viral load and have a higher risk of death.

Publishing their findings in the journal AIDS, researchers analyzed data from 15 cohort studies of Europeans living with HIV. There were 24,069 individuals in the overall cohort, all adults who had first started taking ARVs between 1996 and 2013.

Nine percent of the cohort had not completed primary school, 32 percent had completed just primary school, 44 percent had a high school diploma and 14 percent had a college degree or its equivalent.

During a cumulative 132,507 years that the cohort members were followed by researchers, 1,081 of them died. The death rate dropped with greater levels of education, a finding that held even when the researchers adjusted the data for various factors.

Seventy-seven percent of the cohort had an undetectable viral load one year after starting ARVs. Those with more education were more likely to achieve full viral suppression. Viral suppression was achieved by 87 percent of those who had attended college, 82 percent of those with a high school education, 85 percent of those who had finished just primary school and 67 percent of those who had not completed primary school.

The differences in viral suppression based on educational level faded over time, so that there was no significant difference after individuals had spent 10 years on HIV treatment. After adjusting the data for various factors, the researchers found that having less than a primary school education and having only a primary school education were associated with a respective 20 percent and 7 percent lower chance of achieving an undetectable viral load.

The higher their educational level, the higher their CD4 count tended to be when individuals started treatment. Nevertheless, the researchers did not find a correlation between education level and the recovery of CD4s after starting treatment for the virus.

To read the aidsmap article, click here.

To read the study abstract, click here.