Routes of Infection: Exports and HIV Incidence in Sub-Saharan Africa

57 Pages Posted: 27 Nov 2007 Last revised: 10 Sep 2022

See all articles by Emily F. Oster

Emily F. Oster

University of Chicago - Department of Economics; National Bureau of Economic Research (NBER)

Date Written: November 2007

Abstract

I generate new data on HIV incidence and prevalence in Africa based on inference from mortality rates. I use these data to relate economic activity (specifically, exports) to new HIV infections in Africa and argue there is a significant and large positive relationship between the two: a doubling of exports leads to as much as a quadrupling in new HIV infections. This relationship is consistent with a model of the epidemic in which truckers and other migrants have higher rates of risky behavior, and their numbers increase in periods with greater exports. I present evidence suggesting that the relationship between exports and HIV is causal and works, at least in part, through increased transit. The result has important policy implications, suggesting (for example) that there is significant value in prevention focused on these transit oriented groups. I apply this result to study the case of Uganda, and argue that a decline in exports in the early 1990s in that country appears to explain between 30% and 60% of the decline in HIV infections. This suggests that the success of the Ugandan anti-HIV education campaign, which encouraged changes in sexual behavior, has been overstated.

Suggested Citation

Oster, Emily F., Routes of Infection: Exports and HIV Incidence in Sub-Saharan Africa (November 2007). NBER Working Paper No. w13610, Available at SSRN: https://ssrn.com/abstract=1032865

Emily F. Oster (Contact Author)

University of Chicago - Department of Economics ( email )

1126 East 59th Street
Chicago, IL 60637
United States

National Bureau of Economic Research (NBER) ( email )

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

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