HIV and sexual behavior change: why not Africa?
Oster, E.
Journal of Health Economics 31(1): 35-49
2012
ISSN/ISBN: 1879-1646 PMID: 22277285 DOI: 10.1016/j.jhealeco.2011.12.006Document Number: 552799
Despite high rates of HIV in Sub-Saharan Africa, and the corresponding high mortality risk associated with risky sexual behavior, behavioral response has been limited. This paper explores three explanations for this: bias in OLS estimates, limited non-HIV life expectancy and limited knowledge. I find support for the first two. First, using a new instrumental variable strategy I find that OLS estimates of the relationship between risky sex and HIV are biased upwards, and IV estimates indicate reductions in risky behavior in response to the epidemic. Second, I find these reductions are larger for individuals who live in areas with higher life expectancy, suggesting high rates of non-HIV mortality suppress behavioral response; this is consistent with optimizing behavior. Using somewhat limited knowledge proxies, I find no evidence that areas with higher knowledge of the epidemic have greater behavior change.
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