IDEAS home Printed from https://ideas.repec.org/a/red/issued/19-55.html
   My bibliography  Save this article

Fertility and HIV Risk in Africa

Author

Listed:
  • Yao Yao

    (Victoria University Wellington)

Abstract

This paper examines the role of social and cultural norms regarding fertility in women's HIV risk in Sub-Saharan Africa. Fertility is highly valued in most African societies, and premarital fertility is often encouraged to facilitate marriage. This incentivizes unprotected premarital sex and escalates HIV risk. I build a rich lifecycle model linking women's decisions concerning sex, fertility and education to HIV infection and calibrate it to match Kenyan data. Quantitative results show that premarital fertility motives account for 13 percent of HIV prevalence among young Kenyan women and that a combination of fertility motives and contraception cost accounts for nearly one-third of this prevalence. Various policies are evaluated. While an HIV treatment subsidy would reduce HIV prevalence to the greatest extent, its effectiveness would be severely mitigated by increased risky sex. (Copyright: Elsevier)

Suggested Citation

  • Yao Yao, 2022. "Fertility and HIV Risk in Africa," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 45, pages 109-133, July.
    • Handle: RePEc:red:issued:19-55
    DOI: 10.1016/j.red.2021.05.005
    as

    Download full text from publisher

    File URL: https://dx.doi.org/10.1016/j.red.2021.05.005
    Download Restriction: Access to full texts is restricted to ScienceDirect subscribers and institutional members. See https://www.sciencedirect.com/ for details.
    File URL: https://libkey.io/10.1016/j.red.2021.05.005?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to look for a different version below or search for a different version of it.

    Other versions of this item:

    References listed on IDEAS

    as
    1. Sebnem Kalemli-Ozcan, 2012. "AIDS, “reversal” of the demographic transition and economic development: evidence from Africa," Journal of Population Economics, Springer;European Society for Population Economics, vol. 25(3), pages 871-897, July.
    2. Tiago Cavalcanti & Georgi Kocharkov & Cezar Santos, 2021. "Family Planning and Development: Aggregate Effects of Contraceptive Use," The Economic Journal, Royal Economic Society, vol. 131(634), pages 624-657.
    3. Daniela Iorio & Raül Santaeulàlia-Llopis, 2011. "Education, HIV Status, and Risky Sexual Behavior: How Much Does the Stage of the HIV Epidemic Matter?," Working Papers 624, Barcelona School of Economics.
    4. T. Paul Schultz, 2004. "Evidence of Returns to Schooling in Africa from Household Surveys: Monitoring and Restructuring the Market for Education," Journal of African Economies, Centre for the Study of African Economies, vol. 13(02), pages 95-148, December.
    5. Rodolfo Manuelli & Emircan Yurdagul, 2021. "AIDS, Human Capital and Development," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 42, pages 178-193, October.
    6. Chinhui Juhn & Sebnem Kalemli-Ozcan & Belgi Turan, 2013. "HIV and fertility in Africa: first evidence from population-based surveys," Journal of Population Economics, Springer;European Society for Population Economics, vol. 26(3), pages 835-853, July.
    7. de Walque, Damien, 2007. "How does the impact of an HIV/AIDS information campaign vary with educational attainment? Evidence from rural Uganda," Journal of Development Economics, Elsevier, vol. 84(2), pages 686-714, November.
    8. Rodolfo Manuelli & Emircan Yurdagul, 2021. "AIDS, Human Capital and Development," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 42, pages 178-193, October.
    9. Friedman, Willa Helterline, 2018. "Antiretroviral drug access and behavior change," Journal of Development Economics, Elsevier, vol. 135(C), pages 392-411.
    10. Gianmarco León & Edward Miguel, 2017. "Risky Transportation Choices and the Value of a Statistical Life," American Economic Journal: Applied Economics, American Economic Association, vol. 9(1), pages 202-228, January.
    11. Esther Duflo & Pascaline Dupas & Michael Kremer, 2015. "Education, HIV, and Early Fertility: Experimental Evidence from Kenya," American Economic Review, American Economic Association, vol. 105(9), pages 2757-2797, September.
    12. Todd Schoellman & Michèle Tertilt, 2006. "Marriage Laws and Growth in Sub-Saharan Africa," American Economic Review, American Economic Association, vol. 96(2), pages 295-298, May.
    13. Michele Tertilt, 2005. "Polygyny, Fertility, and Savings," Journal of Political Economy, University of Chicago Press, vol. 113(6), pages 1341-1370, December.
    14. Alsan, Marcella M. & Cutler, David M., 2013. "Girls’ education and HIV risk: Evidence from Uganda," Journal of Health Economics, Elsevier, vol. 32(5), pages 863-872.
    15. Jeremy Greenwood & Nezih Guner & Karen A. Kopecky, 2019. "The Wife's Protector: A Quantitative Theory Linking Contraceptive Technology with the Decline in Marriage," Working Papers wp2019_1912, CEMFI.
    16. Michael Kremer & Jessica Leino & Edward Miguel & Alix Peterson Zwane, 2011. "Spring Cleaning: Rural Water Impacts, Valuation, and Property Rights Institutions," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 126(1), pages 145-205.
    17. Raouf Boucekkine & Rodolphe Desbordes & Hélène Latzer, 2009. "How do epidemics induce behavioral changes?," Journal of Economic Growth, Springer, vol. 14(3), pages 233-264, September.
    18. Matthias Doepke & Fabian Kindermann, 2019. "Bargaining over Babies: Theory, Evidence, and Policy Implications," American Economic Review, American Economic Association, vol. 109(9), pages 3264-3306, September.
    19. Alwyn Young, 2007. "In sorrow to bring forth children: fertility amidst the plague of HIV," Journal of Economic Growth, Springer, vol. 12(4), pages 283-327, December.
    20. Damien de Walque & Harounan Kazianga & Mead Over, 2012. "Antiretroviral Therapy Perceived Efficacy and Risky Sexual Behaviors: Evidence from Mozambique," Economic Development and Cultural Change, University of Chicago Press, vol. 61(1), pages 97-126.
    21. Rebecca L. Thornton, 2008. "The Demand for, and Impact of, Learning HIV Status," American Economic Review, American Economic Association, vol. 98(5), pages 1829-1863, December.
    22. Emily Oster, 2005. "Sexually Transmitted Infections, Sexual Behavior, and the HIV/AIDS Epidemic," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 120(2), pages 467-515.
    23. Jeremy Magruder, 2011. "Marital Shopping and Epidemic AIDS," Demography, Springer;Population Association of America (PAA), vol. 48(4), pages 1401-1428, November.
    24. Nava Ashraf & Erica Field & Jean Lee, 2014. "Household Bargaining and Excess Fertility: An Experimental Study in Zambia," American Economic Review, American Economic Association, vol. 104(7), pages 2210-2237, July.
    25. Michael Kremer, 1996. "Integrating Behavioral Choice into Epidemiological Models of AIDS," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 549-573.
    26. Jane Fortson, 2008. "The gradient in sub-saharan Africa: Socioeconomic status and HIV/AIDS," Demography, Springer;Population Association of America (PAA), vol. 45(2), pages 303-322, May.
    27. Michèle Tertilt, 2006. "Polygyny, Women's Rights, and Development," Journal of the European Economic Association, MIT Press, vol. 4(2-3), pages 523-530, 04-05.
    28. Jeremy Greenwood & Philipp Kircher & Cezar Santos & Michèle Tertilt, 2017. "The Role of Marriage in Fighting HIV: A Quantitative Illustration for Malawi," American Economic Review, American Economic Association, vol. 107(5), pages 158-162, May.
    29. Alwyn Young, 2005. "The Gift of the Dying: The Tragedy of AIDS and the Welfare of Future African Generations," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 120(2), pages 423-466.
    30. Michael Kremer, 1996. "Integrating Behavioral Choice into Epidemiological Models of the AIDS Epidemic," NBER Working Papers 5428, National Bureau of Economic Research, Inc.
    31. Damien de Walque, 2009. "Does Education Affect HIV Status? Evidence from five African Countries," The World Bank Economic Review, World Bank, vol. 23(2), pages 209-233, June.
    32. Gallant, Melanie & Maticka-Tyndale, Eleanor, 2004. "School-based HIV prevention programmes for African youth," Social Science & Medicine, Elsevier, vol. 58(7), pages 1337-1351, April.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Yao Yao, 2022. "Fertility and HIV Risk in Africa," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 45, pages 109-133, July.
    2. Yao, Yao, 2016. "Fertility and HIV risk in Africa," Working Paper Series 19501, Victoria University of Wellington, School of Economics and Finance.
    3. Jeremy Greenwood & Philipp Kircher & Cezar Santos & Michèle Tertilt, 2019. "An Equilibrium Model of the African HIV/AIDS Epidemic," Econometrica, Econometric Society, vol. 87(4), pages 1081-1113, July.
    4. David E. Bloom & Michael Kuhn & Klaus Prettner, 2022. "Modern Infectious Diseases: Macroeconomic Impacts and Policy Responses," Journal of Economic Literature, American Economic Association, vol. 60(1), pages 85-131, March.
    5. Chinhui Juhn & Sebnem Kalemli-Ozcan & Belgi Turan, 2013. "HIV and fertility in Africa: first evidence from population-based surveys," Journal of Population Economics, Springer;European Society for Population Economics, vol. 26(3), pages 835-853, July.
    6. Dick Durevall & Annika Lindskog, 2016. "Adult Mortality, AIDS, and Fertility in Rural Malawi," The Developing Economies, Institute of Developing Economies, vol. 54(3), pages 215-242, September.
    7. Bertocchi, Graziella & Dimico, Arcangelo, 2019. "The long-term determinants of female HIV infection in Africa: The slave trade, polygyny, and sexual behavior," Journal of Development Economics, Elsevier, vol. 140(C), pages 90-105.
    8. Friedman, Willa Helterline, 2018. "Antiretroviral drug access and behavior change," Journal of Development Economics, Elsevier, vol. 135(C), pages 392-411.
    9. Sebnem Kalemli-Ozcan, 2012. "AIDS, “reversal” of the demographic transition and economic development: evidence from Africa," Journal of Population Economics, Springer;European Society for Population Economics, vol. 25(3), pages 871-897, July.
    10. David Mmopelwa & Oliver Morrissey & Trudy Owens, 2021. "HIV/AIDS and sexual behaviour in Botswana," Discussion Papers 2021-03, University of Nottingham, CREDIT.
    11. Esther Duflo & Pascaline Dupas & Michael Kremer, 2015. "Education, HIV, and Early Fertility: Experimental Evidence from Kenya," American Economic Review, American Economic Association, vol. 105(9), pages 2757-2797, September.
    12. Gani Aldashev & Jean-Marie Baland, 2012. "Awareness and AIDS: A Political Economy Perspective," Working Papers 1204, University of Namur, Department of Economics.
    13. Wilson, Nicholas, 2015. "Child mortality risk and fertility: Evidence from prevention of mother-to-child transmission of HIV," Journal of Development Economics, Elsevier, vol. 116(C), pages 74-88.
    14. Yoo-Mi Chin & Nicholas Wilson, 2018. "Disease risk and fertility: evidence from the HIV/AIDS pandemic," Journal of Population Economics, Springer;European Society for Population Economics, vol. 31(2), pages 429-451, April.
    15. Okada, Keisuke, 2012. "The effects of female HIV/AIDS status on fertility and child health in Cambodia," Journal of Asian Economics, Elsevier, vol. 23(5), pages 560-570.
    16. Bloom, David E. & Kuhn, Michael & Prettner, Klaus, 2017. "Africa'S Prospects For Enjoying A Demographic Dividend," Journal of Demographic Economics, Cambridge University Press, vol. 83(1), pages 63-76, March.
    17. Boucekkine, Raouf & Laffargue, Jean-Pierre, 2010. "On the distributional consequences of epidemics," Journal of Economic Dynamics and Control, Elsevier, vol. 34(2), pages 231-245, February.
    18. Kudo, Yuya, 2017. "Why Is the Practice of Levirate Marriage Disappearing in Africa? HIV/AIDS as an Agent of Institutional Change," IDE Discussion Papers 627, Institute of Developing Economies, Japan External Trade Organization(JETRO).
    19. Durevall, Dick & Lindskog, Annika, 2009. "How Does Communal HIV/AIDS Affect Fertility? - Evidence from Malawi," Working Papers in Economics 369, University of Gothenburg, Department of Economics, revised 25 Aug 2009.
    20. Vasilakis, Chrysovalantis, 2012. "The social economic impact of AIDS: Accounting for intergenerational transmission, productivity and fertility," Economic Modelling, Elsevier, vol. 29(2), pages 369-381.

    More about this item

    Keywords

    Fertility; HIV; Africa;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • O11 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Macroeconomic Analyses of Economic Development

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:red:issued:19-55. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Christian Zimmermann (email available below). General contact details of provider: https://edirc.repec.org/data/sedddea.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.