HIV prevalence and poverty in Africa : micro and macro-econometric evidence applied to Burkina Faso
Based on the data of the Demographic and Health Survey, and of the Household Priority Survey, carried out in 2003, the present study, examining the factors of the HIV prevalence in Burkina Faso, provides two conclusions. Firstly, the fight against poverty is not necessarily a means of reducing at the same time in a drastic way the HIV/AIDS prevalence, an assertion based on several elements of empirical analysis. First of all, the concentration curve, measuring the « socioeconomic » inequality of the seroprevalence, is « pro-poor ». Then, the micro-econometric estimates of the probit models suggest a positive relation between the HIV prevalence of the adult women and men, and the standard of living of the individuals. At the same time, the probit models highlight a probability of HIV prevalence increasing with : (i) the age, and ; (ii) the localization in Ouagadougou, the capital, and in the majority of the areas of the west and south-west of the country, compared to the other zones. On the other hand, the sexual relations with condoms reduce the chances of seroprevalence, an effect growing with the wealth of the households. Lastly, the macro-econometric approach reveals the existence of a positive (negative) relation between, on the one hand, the level of the regional HIV prevalence, and, on the other hand, the average monetary provincial standard of living (the poverty) of the households. At the same time, the relation between the HIV prevalence and the poverty, apprehended at the regional level, is not linear. Moreover, the estimate of the spatial econometrics models indicates an impact of the crisis of Côte d’Ivoire on the HIV prevalence in Burkina Faso, consecutively with the massive return of a large number of refugees, displaced or repatriated persons originating from Côte d’Ivoire – in particular, since 2000 –, country where the seroprevalence is, on average, five times higher than in Burkina Faso. Secondly, and correlatively, the relation between the HIV prevalence and poverty is questioned. First of all, some structural factors could contribute to skew the relation between the resources of the households and the prevalence of the HIV/AIDS. On the one hand, the persistence of cognitive and behavioral factors inherent to the traditional society, in spite of the high rate of economic growth per capita which prevailed during two last decades. In particular, the social construction of the female attributes and roles confers to men a statute of « decision-makers » with regard to the sexual intercourse, while the persistence of the secular beliefs contributes to minimize the perception of the HIV/SIDA in terms of risks, independently of the standard of living. In addition, the two geographical subsets where the HIV prevalence is higher than the national average, tend to have higher regional averages per capita expenditure, compared to the other zones. In addition, the enclavement of Burkina Faso required a development of the road and railway traffic with the countries bordering, in particular Côte d’Ivoire. So, it may be that the structural conditions of the process of development of Burkina Faso, concomitant with significant flows of exchange of goods, services and labour with a country where the prevalence of the HIV is particularly high, constitute an element of explanation of the positive relation between the resources of the households and the HIV seroprevalence. Then, factors related to the conjuncture probably contributed to reinforce the opposite relation between the HIV seroprevalence and poverty, the macro-econometric analysis highlighting a direct relation between the massive return of the migrants of Côte d'Ivoire and the level of HIV prevalence in Burkina Faso. (Full text in english)
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