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Sexually Transmitted Infections, Sexual Behavior, and the HIV/AIDS Epidemic

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Author Info
Emily Oster

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Abstract

Forty million people are infected with HIV worldwide; twenty-five million of them are in Sub-Saharan Africa. This paper addresses the question of why Africa has been so heavily affected by HIV, and what explains the variation within Africa. I present a model that decomposes epidemic level into differences in sexual behavior and differences in viral transmission rates. I argue, using evidence drawn from the existing medical literature, that Africa has very high HIV transmission rates, likely due to high rates of other untreated sexually transmitted infections, while transmission rates in the United States are low. The difference in transmission rates is large enough to explain the observed difference in prevalence between the United States and Sub-Saharan Africa. The model also provides a good fit to cross-country data within Africa and suggests that, in contrast to the intracontinental results, differences within that continent can be attributed to differences in sexual behavior and epidemic timing. The results suggest that cost-effective policy interventions would focus on decreasing transmission rates within Africa, possibly by treating other untreated sexually transmitted infections. © 2005 MIT Press

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Publisher Info
Article provided by MIT Press in its journal The Quarterly Journal of Economics.

Volume (Year): 120 (2005)
Issue (Month): 2 (May)
Pages: 467-515
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Handle: RePEc:tpr:qjecon:v:120:y:2005:i:2:p:467-515

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  1. Sebnem Kalemli-Ozcan, 2006. "AIDS, "Reversal" of the Demographic Transition and Economic Development: Evidence from Africa," NBER Working Papers 12181, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  2. Emily Oster, 2007. "HIV and Sexual Behavior Change: Why Not Africa?," NBER Working Papers 13049, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  3. David Canning, 2006. "The Economics of HIV/AIDS in Low-Income Countries: The Case for Prevention," PGDA Working Papers 1806, Program on the Global Demography of Aging. [Downloadable!]
    Other versions:
  4. Robinson, Jonathan & Yeh, Ethan, 2008. "Transactional Sex as a Response to Risk in Western Kenya," MPRA Paper 7350, University Library of Munich, Germany. [Downloadable!]
    Other versions:
  5. Djemaï, Elodie, 2008. "Is the risk taking of HIV-infection influenced by income uncertainty? : Empirical Evidence from Sub-Saharan Africa," MPRA Paper 11731, University Library of Munich, Germany. [Downloadable!]
  6. Chris Papageorgiou & Petia Stoytcheva, . "What Do We Know About the Impact of AIDS on Cross-Country Income So Far?," Departmental Working Papers 2005-01, Department of Economics, Louisiana State University. [Downloadable!]
  7. Djemaï, Elodie, 2008. "Risk Taking of HIV-Infection and Income Uncertainty: Empirical Evidence from Sub-Saharan Africa," MPRA Paper 11740, University Library of Munich, Germany, revised 09 Jan 2009. [Downloadable!]
  8. Yamauchi, Futoshi & Buthelezi, Thabani & Velia, Myriam, 2006. "Gender, labor, and prime-age adult mortality: evidence from South Africa," FCND discussion papers 208, International Food Policy Research Institute (IFPRI). [Downloadable!]
  9. Leigh Johnson & Rob Dorrington & Debbie Bradshaw & Victoria Pillay-Van Wyk & Thomas Rehle, 2009. "Sexual behaviour patterns in South Africa and their association with the spread of HIV: insights from a mathematical model," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 21(11), pages 289-340, September. [Downloadable!]
  10. Shorish, Jamsheed, 2007. "Welfare Analysis of HIV/AIDS: Formulating and Computing a Continuous Time Overlapping Generations Policy Model," Economics Series 211, Institute for Advanced Studies. [Downloadable!]
    Other versions:
  11. de Walque, Damien, 2006. "Discordant couples : HIV infection among couples in Burkina Faso, Cameroon, Ghana, Kenya, and Tanzania," Policy Research Working Paper Series 3956, The World Bank. [Downloadable!]
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