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Routes of Infection: Exports and HIV Incidence in Sub-Saharan Africa

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  • Emily Oster

Abstract

I generate new data on HIV incidence and prevalence in Africa based on inference from mortality rates. I use these data to relate economic activity (specifically, exports) to new HIV infections in Africa and argue there is a significant and large positive relationship between the two: a doubling of exports leads to as much as a quadrupling in new HIV infections. This relationship is consistent with a model of the epidemic in which truckers and other migrants have higher rates of risky behavior, and their numbers increase in periods with greater exports. I present evidence suggesting that the relationship between exports and HIV is causal and works, at least in part, through increased transit. The result has important policy implications, suggesting (for example) that there is significant value in prevention focused on these transit oriented groups. I apply this result to study the case of Uganda, and argue that a decline in exports in the early 1990s in that country appears to explain between 30% and 60% of the decline in HIV infections. This suggests that the success of the Ugandan anti-HIV education campaign, which encouraged changes in sexual behavior, has been overstated.

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Bibliographic Info

Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 13610.

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Date of creation: Nov 2007
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Publication status: published as Oster, E. (2012), ROUTES OF INFECTION: EXPORTS AND HIV INCIDENCE IN SUB-SAHARAN AFRICA. Journal of the European Economic Association, 10: 1025–1058. doi: 10.1111/j.1542-4774.2012.01075.x
Handle: RePEc:nbr:nberwo:13610

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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.
  2. Ian Timæus & Momodou Jasseh, 2004. "Adult mortality in sub-Saharan Africa: Evidence from demographic and health surveys," Demography, Springer, vol. 41(4), pages 757-772, November.
  3. Murphy, Kevin M & Welch, Finis, 1990. "Empirical Age-Earnings Profiles," Journal of Labor Economics, University of Chicago Press, University of Chicago Press, vol. 8(2), pages 202-29, April.
  4. Emmanuela Gakidou & Gary King, 2006. "Death by survey: Estimating adult mortality without selection bias from sibling survival data," Demography, Springer, vol. 43(3), pages 569-585, August.
  5. Emily Oster, 2007. "HIV and Sexual Behavior Change: Why Not Africa?," NBER Working Papers 13049, National Bureau of Economic Research, Inc.
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