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Who gets AIDS and how ? The determinants of HIV infection and sexual behaviors in Burkina Faso, Cameroon, Ghana, Kenya, and Tanzania

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  • de Walque, Damien

Abstract

This paper analyzes the determinants of HIV infection and associated sexual behaviors using data from the first five Demographic and Health Surveys to include HIV testing for a representative sample of the adult population. Emerging from a wealth of country relevant results, four important findings can be generalized. First, married women who engage in extra-marital sex are less likely to use condoms than single women when doing so. Second, having been in successive marriages is a significant risk-factor, as evidenced by the results on HIV infection and on sexual behaviors. Contrary to prima facie evidence, education is not associated positively with HIV status. But schooling is one of the most consistent predictors of behavior and knowledge: education predicts protective behaviors like condom use, use of counseling and testing, discussion among spouses and knowledge, but it also predicts a higher level of infidelity and a lower level of abstinence. Finally, male circumcision and female genital mutilation are often associated with sexual behaviors, practices, and knowledge related to AIDS. This might explain why in the analysis in the five countries there is no significant negative association between male circumcision and HIV status, despite recent evidence from a randomized control trial that male circumcision has a protective effect.

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  • de Walque, Damien, 2006. "Who gets AIDS and how ? The determinants of HIV infection and sexual behaviors in Burkina Faso, Cameroon, Ghana, Kenya, and Tanzania," Policy Research Working Paper Series 3844, The World Bank.
  • Handle: RePEc:wbk:wbrwps:3844
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    1. Bertran Auvert & Dirk Taljaard & Emmanuel Lagarde & Joëlle Sobngwi-Tambekou & Rémi Sitta & Adrian Puren, 2005. "Randomized, Controlled Intervention Trial of Male Circumcision for Reduction of HIV Infection Risk: The ANRS 1265 Trial," PLOS Medicine, Public Library of Science, vol. 2(11), pages 1-1, October.
    2. Mark Gersovitz, 2005. "The HIV Epidemic in Four African Countries Seen through the Demographic and Health Surveys," Journal of African Economies, Centre for the Study of African Economies (CSAE), vol. 14(2), pages 191-246, June.
    3. Robert Clark & Désiré Vencatachellum, 2003. "Economic Development and HIV/AIDS Prevalence," CIRANO Working Papers 2003s-25, CIRANO.
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    Cited by:

    1. Kathleen Beegle & Joachim De Weerdt & Stefan Dercon, 2008. "Adult Mortality and Consumption Growth in the Age of HIV/AIDS," Economic Development and Cultural Change, University of Chicago Press, vol. 56(2), pages 299-326, January.
    2. 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.
    3. DJEMAI, Elodie, 2018. "Roads and the spread of HIV in Africa," Journal of Health Economics, Elsevier, vol. 60(C), pages 118-141.
    4. Pedro de Araujo, 2008. "The Socio-Economic Distribution of AIDS Incidence and Output," Caepr Working Papers 2008-014_updated, Center for Applied Economics and Policy Research, Economics Department, Indiana University Bloomington.
    5. Pedro de Araujo, 2008. "The Socio-Economic Distribution of AIDS Incidence and Output," Caepr Working Papers 2008-014_updated, Center for Applied Economics and Policy Research, Economics Department, Indiana University Bloomington, revised Sep 2008.
    6. Djemaï, Elodie, 2008. "Risk Taking of HIV-Infection and Income Uncertainty: Empirical Evidence from Sub-Saharan Africa," MPRA Paper 15605, University Library of Munich, Germany, revised 09 Jan 2009.
    7. Juan Leon & David P. Baker & Daniel Salinas & Adrienne Henck, 2017. "Is education a risk factor or social vaccine against HIV/AIDS in Sub-Saharan Africa? The effect of schooling across public health periods," Journal of Population Research, Springer, vol. 34(4), pages 347-372, December.
    8. David M. Cutler & Adriana Lleras-Muney, 2012. "Education and Health: Insights from International Comparisons," NBER Working Papers 17738, National Bureau of Economic Research, Inc.
    9. Pedro de Araujo, 2008. "The Socio-Economic Distribution of AIDS Incidence and Output," CAEPR Working Papers 2008-014, Center for Applied Economics and Policy Research, Department of Economics, Indiana University Bloomington, revised Sep 2008.
    10. Fabrice Murtin & Federica Marzo, 2007. "HIV/AIDS and Poverty in South Africa: a Bayesian Estimation," Cahiers de recherche 07-08, Departement d'Economique de l'École de gestion à l'Université de Sherbrooke.
    11. Smriti Agarwal & Pedro de Araujo & Jayash Paudel, 2013. "HIV-Related Knowledge and Risky Sexual Behaviour in Sub-Saharan Africa," Oxford Development Studies, Taylor & Francis Journals, vol. 41(2), pages 173-189, June.
    12. Kathleen Beegle & Sofya Krutikova, 2008. "Adult mortality and children’s transition into marriage," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 19(42), pages 1551-1574.
    13. Chris Richard Kenyon & Lung Vu & Joris Menten & Brendan Maughan-Brown, 2014. "Male Circumcision and Sexual Risk Behaviors May Contribute to Considerable Ethnic Disparities in HIV Prevalence in Kenya: An Ecological Analysis," PLOS ONE, Public Library of Science, vol. 9(8), pages 1-12, August.
    14. Sarah Baird & Ephraim Chirwa & Craig McIntosh & Berk Özler, 2010. "The short‐term impacts of a schooling conditional cash transfer program on the sexual behavior of young women," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 55-68, September.
    15. Robert J. Brent, 2010. "Setting Priorities for HIV/AIDS Interventions," Books, Edward Elgar Publishing, number 12742.
    16. Damien De Walque, 2007. "Sero‐Discordant Couples in Five African Countries: Implications for Prevention Strategies," Population and Development Review, The Population Council, Inc., vol. 33(3), pages 501-523, September.
    17. Pedro de Araujo, 2008. "Socio-Economic Status, HIV/AIDS Knowledge and Stigma, and Sexual Behavior in India," CAEPR Working Papers 2008-019, Center for Applied Economics and Policy Research, Department of Economics, Indiana University Bloomington, revised Sep 2008.
    18. Fabrice Murtin & Federica Marzo, 2013. "Hiv/Aids And Poverty In South Africa: A Bayesian Estimation Of Selection Models With Correlated Fixed-Effects," South African Journal of Economics, Economic Society of South Africa, vol. 81(1), pages 118-139, March.
    19. Ana María Iregui-Bohórquez & Ligia Alba Melo-Becerra & María Teresa Ramírez-Giraldo, 2015. "Risky Health Behaviors: Evidence for an Emerging Economy," BORRADORES DE ECONOMIA 013040, BANCO DE LA REPÚBLICA.
    20. Marjorie Opuni & Amber Peterman & David Bishai, 2011. "Inequality in prime‐age adult deaths in a high AIDS mortality setting: does the measure of economic status matter?," Health Economics, John Wiley & Sons, Ltd., vol. 20(11), pages 1298-1311, November.
    21. Pedro de Araujo, 2008. "Socio-Economic Status, HIV/AIDS Knowledge and Stigma, and Sexual Behavior in India," Caepr Working Papers 2008-019_updated, Center for Applied Economics and Policy Research, Economics Department, Indiana University Bloomington, revised Sep 2008.
    22. Elodie Djemai, 2017. "Roads and the Spread of AIDS in Africa," Working Papers DT/2017/16, DIAL (Développement, Institutions et Mondialisation).
    23. 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.

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    Keywords

    HIV AIDS; Adolescent Health; Population&Development; Anthropology; Gender and Development;
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