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Sex and the mission: the Conflicting Effects of early Christian Missions on HIV in sub-Saharan Africa

Author

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  • Julia CAGÉ

    (Sciences Po Paris and CEPR)

  • Valeria RUEDA

    (School of Economics, University of Nothingam)

Abstract

This paper investigates the long-term impact of historical missionary activity on HIV in sub-Saharan Africa. On the one hand, missionaries were the first to invest in modern medicine in the region. On the other hand, Christianity influenced sexual beliefs and behaviors that affect the risk of contagion. We build a new geocoded dataset locating Protestant and Catholic missions in the early 20th century, as well as the health facilities they invested in, that we combine with individual-level Demographic and Health Survey data. With these data, we can address separately these two channels, within regions close to historical missionary settlements. First, we show that proximity to historical missionary health facilities decreases the likelihood of HIV; persistence in healthcare provision and safer sexual behaviors in the region explain this result. Second, we show that regions close to historical missionary settlements exhibit higher likelihood of HIV. This effect is driven by the Christian population in our sample. This suggests conversion to Christianity as a possible explanatory channel. Our findings are robust to alternative specifications addressing selection.

Suggested Citation

  • Julia CAGÉ & Valeria RUEDA, 2020. "Sex and the mission: the Conflicting Effects of early Christian Missions on HIV in sub-Saharan Africa," JODE - Journal of Demographic Economics, Cambridge University Press, vol. 86(3), pages 213-257, September.
    • Handle: RePEc:ctl:louvde:v:86:y:2020:i:3:p:213-257
    DOI: 10.1017/dem.2019.16
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    1. repec:spo:wpmain:info:hdl:2441/7ta31jvjhg900qkformecj6b01 is not listed on IDEAS
    2. Sascha O. Becker & Amma Panin & Steven J. Pfaff & Jared Rubin, 2025. "Religion and Economic Development: Past, Present, and Future," Working Papers 25-01, Chapman University, Economic Science Institute.
    3. Sascha O. Becker & Jared Rubin & Ludger Woessmann, 2024. "Religion and Growth," Journal of Economic Literature, American Economic Association, vol. 62(3), pages 1094-1142, September.
    4. Sascha O. Becker & Steven Pfaff, 2022. "Church and State in Historical Political Economy," Monash Economics Working Papers 2022-09, Monash University, Department of Economics.
    5. Ananyev, Maxim & Poyker, Michael, 2021. "Christian missions and anti-gay attitudes in Africa," Journal of Economic Behavior & Organization, Elsevier, vol. 184(C), pages 359-374.
    6. Fenske, James & Gupta, Bishnupriya & Neumann, Cora, 2022. "Missing Women In Colonial India," CEPR Discussion Papers 17189, C.E.P.R. Discussion Papers.
    7. Graziella Bertocchi & Arcangelo Dimico, 2020. "COVID-19, Race, and Redlining," Center for Economic Research (RECent) 145, University of Modena and Reggio E., Dept. of Economics "Marco Biagi".
    8. Jedwab, Remi & Meier zu Selhausen, Felix & Moradi, Alexander, 2021. "Christianization without economic development: Evidence from missions in Ghana," Journal of Economic Behavior & Organization, Elsevier, vol. 190(C), pages 573-596.
    9. Congdon Fors, Heather & Isaksson, Ann-Sofie & Annika, Lindskog, 2023. "Changing local customs: Long-run impacts of the earliest campaigns against female genital cutting," Working Papers in Economics 831, University of Gothenburg, Department of Economics.
    10. Fenske, James & Gupta, Bishnupriya & Mukhopadhyay, Anwesh, 2025. "Colonial Persistence," CAGE Online Working Paper Series 752, Competitive Advantage in the Global Economy (CAGE).
    11. Bernhard C. Dannemann & Erkan Goeren, 2025. "Where Does the Money Go? Spatial Patterns in the Distribution of World Bank Foreign Aid Projects," Working Papers V-451-25, University of Oldenburg, Department of Economics, revised Mar 2025.
    12. Mihaylova, Iva, 2023. "Perpetuating the malign legacy of colonialism? Traditional chiefs’ power and deforestation in Sierra Leone," World Development, Elsevier, vol. 164(C).
    13. Dozie Okoye & Roland Pongou, 2024. "Missions, fertility transition, and the reversal of fortunes: evidence from border discontinuities in the emirates of Nigeria," Journal of Economic Growth, Springer, vol. 29(2), pages 251-325, June.
    14. Fenske, James & Wang, Shizhuo, 2023. "Tradition and mortality: Evidence from twin infanticide in Africa," Journal of Development Economics, Elsevier, vol. 163(C).
    15. Congdon Fors, Heather & Isaksson, Ann-Sofie & Lindskog, Annika, 2024. "Changing local customs: The long run impacts of Christian missions on female genital cutting in Africa," Journal of Development Economics, Elsevier, vol. 166(C).
    16. Remi Jedwab & Felix Meier zu Selhausen & Alexander Moradi, 2022. "The economics of missionary expansion: evidence from Africa and implications for development," Journal of Economic Growth, Springer, vol. 27(2), pages 149-192, June.
    17. Becker, Bastian & Schmitt, Carina, 2023. "License to educate: The role of national networks in colonial empires," World Development, Elsevier, vol. 169(C).
    18. Dozie & Roland Pongou, 2021. "Missions and Heterogeneous Social Change: Evidence from Border Discontinuities in the Emirates of Nigeria," Working Papers 2112E Classification-I20,, University of Ottawa, Department of Economics.

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    Keywords

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    JEL classification:

    • D72 - Microeconomics - - Analysis of Collective Decision-Making - - - Political Processes: Rent-seeking, Lobbying, Elections, Legislatures, and Voting Behavior
    • N37 - Economic History - - Labor and Consumers, Demography, Education, Health, Welfare, Income, Wealth, Religion, and Philanthropy - - - Africa; Oceania
    • N77 - Economic History - - Economic History: Transport, International and Domestic Trade, Energy, and Other Services - - - Africa; Oceania
    • O33 - Economic Development, Innovation, Technological Change, and Growth - - Innovation; Research and Development; Technological Change; Intellectual Property Rights - - - Technological Change: Choices and Consequences; Diffusion Processes
    • Z12 - Other Special Topics - - Cultural Economics - - - Religion
    • Z13 - Other Special Topics - - Cultural Economics - - - Economic Sociology; Economic Anthropology; Language; Social and Economic Stratification

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