[go: up one dir, main page]
IDEAS home Printed from https://ideas.repec.org/p/fpr/ifprid/1146.html
   My bibliography  Save this paper

Income shocks and HIV in Sub-Saharan Africa:

Author

Listed:
  • Burke, Marshall
  • Gong, Erick
  • Jones, Kelly
Abstract
Poverty is commonly cited as a key driver of the HIV/AIDS epidemic, yet little causal evidence exists linking economic conditions to actual disease outcomes. Using data on more than 200,000 individuals across 19 Sub-Saharan African countries, we present evidence that negative income shocks can lead to substantial increases in HIV prevalence, particularly for women in rural areas. Building on recent work showing that income shortfalls can induce some women to engage in higher-risk sex, we match data on individuals' HIV status from the Demographic and Health Surveys to data on recent variation in local rainfall, a primary (and exogenous) source of variation in income for rural households in Africa. We find that infection rates for women (men) in HIV-endemic rural areas increase significantly by 14 percent (11 percent) for every drought event experienced in the previous 10 years. Further analysis suggests that women most affected by the shocks (that is, those engaged in agriculture) are driving the women's results; these women are partnering with men least affected (those employed outside agriculture). Our findings suggest a role for formal insurance and social safety nets in tackling the HIV/AIDS epidemic.

Suggested Citation

  • Burke, Marshall & Gong, Erick & Jones, Kelly, 2011. "Income shocks and HIV in Sub-Saharan Africa:," IFPRI discussion papers 1146, International Food Policy Research Institute (IFPRI).
    • Handle: RePEc:fpr:ifprid:1146
    as

    Download full text from publisher

    File URL: http://www.ifpri.org/sites/default/files/publications/ifpridp01146.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Harold Alderman & John Hoddinott & Bill Kinsey, 2006. "Long term consequences of early childhood malnutrition," Oxford Economic Papers, Oxford University Press, vol. 58(3), pages 450-474, July.
    2. Benjamin F. Jones & Benjamin A. Olken, 2010. "Climate Shocks and Exports," American Economic Review, American Economic Association, vol. 100(2), pages 454-459, May.
    3. Rosenzweig, Mark R & Wolpin, Kenneth I, 1993. "Credit Market Constraints, Consumption Smoothing, and the Accumulation of Durable Production Assets in Low-Income Countries: Investment in Bullocks in India," Journal of Political Economy, University of Chicago Press, vol. 101(2), pages 223-244, April.
    4. Osili, Una Okonkwo & Long, Bridget Terry, 2008. "Does female schooling reduce fertility? Evidence from Nigeria," Journal of Development Economics, Elsevier, vol. 87(1), pages 57-75, August.
    5. Sharon Maccini & Dean Yang, 2009. "Under the Weather: Health, Schooling, and Economic Consequences of Early-Life Rainfall," American Economic Review, American Economic Association, vol. 99(3), pages 1006-1026, June.
    6. Oster, Emily, 2012. "HIV and sexual behavior change: Why not Africa?," Journal of Health Economics, Elsevier, vol. 31(1), pages 35-49.
    7. 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.
    8. Skoufias, Emmanuel, 2003. "Economic Crises and Natural Disasters: Coping Strategies and Policy Implications," World Development, Elsevier, vol. 31(7), pages 1087-1102, July.
    9. Dunkle, Kristin L. & Jewkes, Rachel K. & Brown, Heather C. & Gray, Glenda E. & McIntryre, James A. & Harlow, Siobán D., 2004. "Transactional sex among women in Soweto, South Africa: prevalence, risk factors and association with HIV infection," Social Science & Medicine, Elsevier, vol. 59(8), pages 1581-1592, October.
    10. Kalemli-Ozcan, Sebnem & Turan, Belgi, 2011. "HIV and fertility revisited," Journal of Development Economics, Elsevier, vol. 96(1), pages 61-65, September.
    11. David S. Lee, 2009. "Training, Wages, and Sample Selection: Estimating Sharp Bounds on Treatment Effects," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 76(3), pages 1071-1102.
    12. Markus Brückner & Antonio Ciccone, 2011. "Rain and the Democratic Window of Opportunity," Econometrica, Econometric Society, vol. 79(3), pages 923-947, May.
    13. Pascaline Dupas, 2011. "Do Teenagers Respond to HIV Risk Information? Evidence from a Field Experiment in Kenya," American Economic Journal: Applied Economics, American Economic Association, vol. 3(1), pages 1-34, January.
    14. Béné, Christophe & Merten, Sonja, 2008. "Women and Fish-for-Sex: Transactional Sex, HIV/AIDS and Gender in African Fisheries," World Development, Elsevier, vol. 36(5), pages 875-899, May.
    15. Friedman, Willa Helterline, 2018. "Antiretroviral drug access and behavior change," Journal of Development Economics, Elsevier, vol. 135(C), pages 392-411.
    16. Emily Oster, 2012. "Routes Of Infection: Exports And Hiv Incidence In Sub-Saharan Africa," Journal of the European Economic Association, European Economic Association, vol. 10(5), pages 1025-1058, October.
    17. Björkman, Martina, 2006. "Income Shocks and Gender Gaps in Education: Evidence from Uganda," Seminar Papers 744, Stockholm University, Institute for International Economic Studies.
    18. Jonathan Robinson & Ethan Yeh, 2012. "Risk-Coping through Sexual Networks: Evidence from Client Transfers in Kenya," Journal of Human Resources, University of Wisconsin Press, vol. 47(1), pages 107-145.
    19. Luke, Nancy, 2006. "Exchange and Condom Use in Informal Sexual Relationships in Urban Kenya," Economic Development and Cultural Change, University of Chicago Press, vol. 54(2), pages 319-348, January.
    20. Davis, Benjamin & Winters, Paul & Carletto, Gero & Covarrubias, Katia & Quiñones, Esteban J. & Zezza, Alberto & Stamoulis, Kostas & Azzarri, Carlo & DiGiuseppe, Stefania, 2010. "A Cross-Country Comparison of Rural Income Generating Activities," World Development, Elsevier, vol. 38(1), pages 48-63, January.
    21. Sarah Baird & Ephraim Chirwa & Craig McIntosh & Berk Ozler, 2009. "The Short-Term Impacts of as Schooling Cash Transfer Program on the Sexual Behavior of Young Women," Working Papers 2010-10, The George Washington University, Institute for International Economic Policy.
    22. Janet Currie, 2009. "Healthy, Wealthy, and Wise: Socioeconomic Status, Poor Health in Childhood, and Human Capital Development," Journal of Economic Literature, American Economic Association, vol. 47(1), pages 87-122, March.
    23. Nicholas Wilson, 2010. "Economic Growth and the HIV/AIDS Pandemic: Evidence from the Early 21st Century Copper Boom," Center for Development Economics 2011-04, Department of Economics, Williams College.
    24. Owen Ozier, 2018. "The Impact of Secondary Schooling in Kenya: A Regression Discontinuity Analysis," Journal of Human Resources, University of Wisconsin Press, vol. 53(1), pages 157-188.
    25. de Walque, Damien & Dow, William H & Nathan, Rose & Abdul, Ramadhani & Abilahi, Faraji & Gong, Erick & Isdahl, Zachary & Jamison, Julian & Jullu, Boniphace & Krishnan, Suneeta & Majura, Albert & Migue, 2012. "Incentivising safe sex: a randomised trial of conditional cash transfers for HIV and sexually transmitted infection prevention in rural Tanzania," Department of Economics, Working Paper Series qt4vw984q0, Department of Economics, Institute for Business and Economic Research, UC Berkeley.
    26. Dupas, Pascaline & Robinson, Jonathan, 2012. "The (hidden) costs of political instability: Evidence from Kenya's 2007 election crisis," Journal of Development Economics, Elsevier, vol. 99(2), pages 314-329.
    27. Melissa Dell & Benjamin F. Jones & Benjamin A. Olken, 2008. "Climate Change and Economic Growth: Evidence from the Last Half Century," NBER Working Papers 14132, National Bureau of Economic Research, Inc.
    28. 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.
    29. Beegle, Kathleen & de Walque, Damien, 2009. "Demographic and socioeconomic patterns of HIV/AIDS prevalence in Africa," Policy Research Working Paper Series 5076, The World Bank.
    30. Jeremy Magruder, 2011. "Marital Shopping and Epidemic AIDS," Demography, Springer;Population Association of America (PAA), vol. 48(4), pages 1401-1428, November.
    31. Hans-Peter Kohler & Rebecca L. Thornton, 2012. "Conditional Cash Transfers and HIV/AIDS Prevention: Unconditionally Promising?," The World Bank Economic Review, World Bank, vol. 26(2), pages 165-190.
    32. Frank Ellis, 2000. "The Determinants of Rural Livelihood Diversification in Developing Countries," Journal of Agricultural Economics, Wiley Blackwell, vol. 51(2), pages 289-302, May.
    33. 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.
    34. Paul Gertler & Manisha Shah & Stefano M. Bertozzi, 2005. "Risky Business: The Market for Unprotected Commercial Sex," Journal of Political Economy, University of Chicago Press, vol. 113(3), pages 518-550, June.
    35. Sarah Baird & Craig McIntosh & Berk Özler, 2011. "Cash or Condition? Evidence from a Cash Transfer Experiment," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 126(4), pages 1709-1753.
    36. AfDB AfDB, . "African Development Report 2001," African Development Report, African Development Bank, number 18 edited by Adeleke Oluwole Salami, August.
    37. Johannes Hoogeveen & Bas van der Klaauw & Gijsbert van Lomwel, 2011. "On the Timing of Marriage, Cattle, and Shocks," Economic Development and Cultural Change, University of Chicago Press, vol. 60(1), pages 121-154.
    38. repec:bla:obuest:v:63:y:2001:i:4:p:409-36 is not listed on IDEAS
    39. Edward Miguel, 2005. "Poverty and Witch Killing," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 72(4), pages 1153-1172.
    40. Lena Edlund & Evelyn Korn, 2002. "A Theory of Prostitution," Journal of Political Economy, University of Chicago Press, vol. 110(1), pages 181-214, February.
    41. Edward Miguel & Shanker Satyanath & Ernest Sergenti, 2004. "Economic Shocks and Civil Conflict: An Instrumental Variables Approach," Journal of Political Economy, University of Chicago Press, vol. 112(4), pages 725-753, August.
    42. John Hoddinott & Bill Kinsey, 2001. "Child Growth in the Time of Drought," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 63(4), pages 409-436, September.
    43. Persson, Torsten & Strömberg, David & Kudamatsu, Masayuki, 2012. "Weather and Infant Mortality in Africa," CEPR Discussion Papers 9222, C.E.P.R. Discussion Papers.
    44. World Bank, 2010. "World Development Indicators 2010," World Bank Publications - Books, The World Bank Group, number 4373.
    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. Jonathan Robinson & Ethan Yeh, 2011. "Transactional Sex as a Response to Risk in Western Kenya," American Economic Journal: Applied Economics, American Economic Association, vol. 3(1), pages 35-64, January.
    2. Jones, Kelly & Gong, Erick, 2021. "Precautionary savings and shock-coping behaviors: Effects of promoting mobile bank savings on transactional sex in Kenya," Journal of Health Economics, Elsevier, vol. 78(C).
    3. Raj Arunachalam & Manisha Shah, 2013. "Compensated for Life: Sex Work and Disease Risk," Journal of Human Resources, University of Wisconsin Press, vol. 48(2), pages 345-369.
    4. de Walque, Damien & Dow, William H. & Gong, Erick, 2014. "Coping with risk : the effects of shocks on reproductive health and transactional sex in rural Tanzania," Policy Research Working Paper Series 6751, The World Bank.
    5. 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.
    6. Andréa Mannberg, 2012. "Risky Sex in a Risky World: Sexual Behavior in an HIV/AIDS Environment," Scandinavian Journal of Economics, Wiley Blackwell, vol. 114(2), pages 296-322, June.
    7. Waage Skjeflo, Sofie & Bruvik Westberg, Nina, 2014. "Learning the hard way? Adapting to climate risk in Tanzania," CLTS Working Papers 4/14, Norwegian University of Life Sciences, Centre for Land Tenure Studies, revised 10 Oct 2019.
    8. Gong, Erick & de Walque, Damien & Dow, William H., 2019. "Coping with risk: Negative shocks, transactional sex, and the limitations of conditional cash transfers," Journal of Health Economics, Elsevier, vol. 67(C).
    9. Melissa Dell & Benjamin F. Jones & Benjamin A. Olken, 2014. "What Do We Learn from the Weather? The New Climate-Economy Literature," Journal of Economic Literature, American Economic Association, vol. 52(3), pages 740-798, September.
    10. 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.
    11. Wilson Nicholas, 2019. "The World’s Oldest Profession? Employment-Age Profiles from the Transactional Sex Market," IZA Journal of Labor Policy, Sciendo & Forschungsinstitut zur Zukunft der Arbeit GmbH (IZA), vol. 9(1), pages 1-17, June.
    12. Wilson, Nicholas, 2016. "Antiretroviral therapy and demand for HIV testing: Evidence from Zambia," Economics & Human Biology, Elsevier, vol. 21(C), pages 221-240.
    13. 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.
    14. Sekhri, Sheetal & Storeygard, Adam, 2014. "Dowry deaths: Response to weather variability in India," Journal of Development Economics, Elsevier, vol. 111(C), pages 212-223.
    15. Nicholas Wilson, 2010. "Economic Growth and the HIV/AIDS Pandemic: Evidence from the Early 21st Century Copper Boom," Center for Development Economics 2011-04, Department of Economics, Williams College.
    16. Andalón, Mabel & Azevedo, João Pedro & Rodríguez-Castelán, Carlos & Sanfelice, Viviane & Valderrama-González, Daniel, 2016. "Weather Shocks and Health at Birth in Colombia," World Development, Elsevier, vol. 82(C), pages 69-82.
    17. Baland, Jean-Marie & Aldashev, Gani, 2012. "Awareness and AIDS: A Political Economy Perspective," CEPR Discussion Papers 8908, C.E.P.R. Discussion Papers.
    18. Cassidy, Rachel & Groot Bruinderink, Marije & Janssens, Wendy & Morsink, Karlijn, 2021. "The power to protect: Household bargaining and female condom use," Journal of Development Economics, Elsevier, vol. 153(C).
    19. Hyland, Marie & Russ, Jason, 2019. "Water as destiny – The long-term impacts of drought in sub-Saharan Africa," World Development, Elsevier, vol. 115(C), pages 30-45.
    20. Friedman, Willa Helterline, 2018. "Antiretroviral drug access and behavior change," Journal of Development Economics, Elsevier, vol. 135(C), pages 392-411.

    More about this item

    Keywords

    HIV/AIDS; Income shocks;

    JEL classification:

    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • O12 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Microeconomic Analyses of Economic Development
    • O55 - Economic Development, Innovation, Technological Change, and Growth - - Economywide Country Studies - - - Africa

    NEP fields

    This paper has been announced in the following NEP Reports:

    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:fpr:ifprid:1146. 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: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/ifprius.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.