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HIV and Sexual Behavior Change: Why Not Africa?

Author

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  • Emily Oster
Abstract
The response of sexual behavior to HIV in Africa is an important input to predicting the path of the epidemic and to focusing prevention efforts. Existing estimates suggest limited behavioral response, but fail to take into account possible differences across individuals. A simple model of sexual behavior choice among forward-looking individuals implies that behavioral response should be larger for those with lower non-HIV mortality risks and those who are richer. I estimate behavioral response using a new instrumental variables strategy, instrumenting for HIV prevalence with distance to the origin of the virus. I find low response on average, consistent with existing literature, but larger responses for those who face lower non-HIV mortality and for those who are richer. I also show suggestive evidence, based on a very simple calibration, that the magnitude of behavioral response in Africa is of a similar order of magnitude to that among gay men in the United States, once differences in income and life expectancy are taken into account.

Suggested Citation

  • Emily Oster, 2007. "HIV and Sexual Behavior Change: Why Not Africa?," NBER Working Papers 13049, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:13049
    Note: EH LS
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    References listed on IDEAS

    as
    1. Angus Deaton, 2009. "Instruments of development: Randomization in the tropics, and the search for the elusive keys to economic development," Working Papers 1128, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing..
    2. Victor R. Fuchs, 1982. "Economic Aspects of Health," NBER Books, National Bureau of Economic Research, Inc, number fuch82-1.
    3. 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.
    4. Feng Gao & Elizabeth Bailes & David L. Robertson & Yalu Chen & Cynthia M. Rodenburg & Scott F. Michael & Larry B. Cummins & Larry O. Arthur & Martine Peeters & George M. Shaw & Paul M. Sharp & Beatric, 1999. "Origin of HIV-1 in the chimpanzee Pan troglodytes troglodytes," Nature, Nature, vol. 397(6718), pages 436-441, February.
    5. Oster Emily, 2010. "Estimating HIV Prevalence and Incidence in Africa from Mortality Data," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 10(1), pages 1-46, September.
    6. Winkelstein Jr., W. & Samuel, M. & Padian, N.S. & Wiley, J.A. & Lang, W. & Anderson, R.E. & Levy, J.A., 1987. "The San Francisco Men's Health Study: III. Reduction in human immunodeficiency virus transmission among homosexual/bisexual men, 1982-86," American Journal of Public Health, American Public Health Association, vol. 77(6), pages 685-689.
    7. David Cutler & Angus Deaton & Adriana Lleras-Muney, 2006. "The Determinants of Mortality," Journal of Economic Perspectives, American Economic Association, vol. 20(3), pages 97-120, Summer.
    8. Gary S. Becker & Tomas J. Philipson & Rodrigo R. Soares, 2005. "The Quantity and Quality of Life and the Evolution of World Inequality," American Economic Review, American Economic Association, vol. 95(1), pages 277-291, March.
    9. 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.
    10. Joshua D. Angrist & Alan B. Krueger, 1990. "The Effect of Age at School Entry on Educational Attainment: An Application of Instrumental Variables with Moments from Two Samples," NBER Working Papers 3571, National Bureau of Economic Research, Inc.
    11. repec:pri:cheawb:deaton%20instruments%20of%20development%20keynes%20lecture%202009.pdf is not listed on IDEAS
    12. Thomas S. Dee & William N. Evans, 2003. "Teen Drinking and Educational Attainment: Evidence from Two-Sample Instrumental Variables Estimates," Journal of Labor Economics, University of Chicago Press, vol. 21(1), pages 178-209, January.
    13. McKusick, L. & Horstman, W. & Coates, T.J., 1985. "AIDS and sexual behavior reported by gay men in San Francisco," American Journal of Public Health, American Public Health Association, vol. 75(5), pages 493-496.
    14. Kevin M. Murphy & Robert H. Topel, 2006. "The Value of Health and Longevity," Journal of Political Economy, University of Chicago Press, vol. 114(5), pages 871-904, October.
    15. 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.
    16. Francis, Andrew M., 2008. "The economics of sexuality: The effect of HIV/AIDS on homosexual behavior in the United States," Journal of Health Economics, Elsevier, vol. 27(3), pages 675-689, May.
    17. repec:pri:rpdevs:instruments_of_development.pdf is not listed on IDEAS
    18. Alan D. Lopez & Colin D. Mathers & Majid Ezzati & Dean T. Jamison & Christopher J. L. Murray, 2006. "Global Burden of Disease and Risk Factors," World Bank Publications - Books, The World Bank Group, number 7039.
    19. 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.
    20. Tomas J. Philipson & William H. Dow & Xavier Sala-i-Martin, 1999. "Longevity Complementarities under Competing Risks," American Economic Review, American Economic Association, vol. 89(5), pages 1358-1371, December.
    21. Dupas, Pascaline, 2005. "Relative Risks and the Market for Sex: Teenagers, Sugar Daddies and HIV in Kenya," MPRA Paper 248, University Library of Munich, Germany, revised Aug 2006.
    22. Kenkel, Donald S, 1991. "Health Behavior, Health Knowledge, and Schooling," Journal of Political Economy, University of Chicago Press, vol. 99(2), pages 287-305, April.
    23. Deon Filmer & Lant Pritchett, 2001. "Estimating Wealth Effects Without Expenditure Data—Or Tears: An Application To Educational Enrollments In States Of India," Demography, Springer;Population Association of America (PAA), vol. 38(1), pages 115-132, February.
    24. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    25. 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.
    26. repec:pri:cheawb:deaton%20instruments%20of%20development%20keynes%20lecture%202009 is not listed on IDEAS
    27. Filmer, Deon & Pritchett, Lant, 1998. "Estimating wealth effects without expenditure data - or tears : with an application to educational enrollments in states of India," Policy Research Working Paper Series 1994, The World Bank.
    28. Pascaline Dupas, 2006. "Relative risks and the market for sex: Teenagers, sugar daddies, and hiv in kenya," Natural Field Experiments 00235, The Field Experiments Website.
    29. Fuchs, Victor R. (ed.), 1982. "Economic Aspects of Health," National Bureau of Economic Research Books, University of Chicago Press, number 9780226267852, August.
    30. Jeffrey Sachs & Pia Malaney, 2002. "The economic and social burden of malaria," Nature, Nature, vol. 415(6872), pages 680-685, February.
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    More about this item

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • J17 - Labor and Demographic Economics - - Demographic Economics - - - Value of Life; Foregone Income
    • O12 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Microeconomic Analyses of Economic Development

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