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Sexually Transmitted Infections, Sexual Behavior and the HIV/AIDS Epidemic

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  • Emily Oster

Abstract

Forty million people are infected with HIV worldwide; twenty-five million of them are in Sub-Saharan Africa. This paper addresses the question of why Africa has been so heavily affected by HIV, and what explains the variation within Africa. I present a model that decomposes epidemic level into differences in sexual behavior and differences in viral transmission rates. I argue, using evidence drawn from the existing medical literature, that Africa has very high HIV transmission rates, likely due to high rates of other untreated sexually transmitted infections. The difference in transmission is large enough to explain the observed difference in prevalence between the United States and Sub-Saharan Africa. The model also provides a good fit to cross-country data within Africa and suggests that, in contrast to the intra-continental results, differences within that continent can be attributed to differences in sexual behavior and epidemic timing. The results suggest that cost-effective policy interventions would focus on decreasing transmission rates within Africa, possibly by treating other untreated sexually transmitted infections.

Suggested Citation

  • Emily Oster, 2005. "Sexually Transmitted Infections, Sexual Behavior and the HIV/AIDS Epidemic," CID Working Papers 4, Center for International Development at Harvard University.
    • Handle: RePEc:cid:wpfacu:4
    as

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    File URL: https://www.hks.harvard.edu/sites/default/files/centers/cid/files/publications/fellow_graduate_student_working_papers/004-2.pdf
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    References listed on IDEAS

    as
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    2. Gray, Peter B., 2004. "HIV and Islam: is HIV prevalence lower among Muslims?," Social Science & Medicine, Elsevier, vol. 58(9), pages 1751-1756, May.
    3. Alwyn Young, 2005. "The Gift of the Dying: The Tragedy of AIDS and the Welfare of Future African Generations," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 120(2), pages 423-466.
    4. 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.
    Full references (including those not matched with items on IDEAS)

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    More about this item

    Keywords

    HIV epidemic; sexual behavior; cost-effectiveness;
    All these keywords.

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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