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Are Africans Practicing Safer Sex? Evidence from Demographic and Health Surveys for Eight Countries

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  • Peter J. Glick
  • David E. Sahn

Abstract

We use repeated rounds of Demographic and Health Survey data from eight African countries to examine changes in and determinants of three HIV risk behaviors: age at first intercourse, number of current sexual partners, and use of condoms. As a prelude, we assess the within-country comparability of DHS surveys over time. We find some evidence of changes in sample composition, which is easily handled in a multivariate framework. More problematic is evidence that people may be changing how they respond to questions about HIV behavior. This likely represents an increase in social desirability bias over time, and where it occurs our estimates of risk reduction are probably upper bounds on the true effects. Overall the picture is one of reductions in risk behaviors over recent 4-6-year intervals, especially with respect to condom use; in some cases the changes seem large given the short time periods involved. With some exceptions, however, the extent and pervasiveness of these changes seems inadequate in relation to the urgency of the public health crisis represented by AIDS. With respect to the determinants of behaviors, schooling and wealth have contradictory impacts on risk behavior: they tend to increase the likelihood of using condoms while also (for men) increasing the demand for additional sexual partners.

Suggested Citation

  • Peter J. Glick & David E. Sahn, 2008. "Are Africans Practicing Safer Sex? Evidence from Demographic and Health Surveys for Eight Countries," Economic Development and Cultural Change, University of Chicago Press, vol. 56(2), pages 397-439, January.
    • Handle: RePEc:ucp:ecdecc:v:56:y:2008:p:397-439
    DOI: 10.1086/522893
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    References listed on IDEAS

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    1. Peter Glick & David Sahn, 2007. "Changes in HIV/AIDS knowledge and testing behavior in Africa: how much and for whom?," Journal of Population Economics, Springer;European Society for Population Economics, vol. 20(2), pages 383-422, April.
    2. Oster, Emily, 2012. "HIV and sexual behavior change: Why not Africa?," Journal of Health Economics, Elsevier, vol. 31(1), pages 35-49.
    3. Peter Glick, 2005. "Scaling Up HIV Voluntary Counseling and Testing in Africa," Evaluation Review, , vol. 29(4), pages 331-357, August.
    4. de Walque, Damien, 2007. "How does the impact of an HIV/AIDS information campaign vary with educational attainment? Evidence from rural Uganda," Journal of Development Economics, Elsevier, vol. 84(2), pages 686-714, November.
    5. David E. Sahn & David Stifel, 2003. "Exploring Alternative Measures of Welfare in the Absence of Expenditure Data," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 49(4), pages 463-489, December.
    6. Ulin, Priscilla R., 1992. "African women and AIDS: Negotiating behavioral change," Social Science & Medicine, Elsevier, vol. 34(1), pages 63-73, January.
    7. Mark Gersovitz, 2005. "The HIV Epidemic in Four African Countries Seen through the Demographic and Health Surveys," Journal of African Economies, Centre for the Study of African Economies, vol. 14(2), pages 191-246, June.
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    2. James R Hargreaves & Calum Davey & Elizabeth Fearon & Bernadette Hensen & Shari Krishnaratne, 2015. "Trends in Socioeconomic Inequalities in HIV Prevalence among Young People in Seven Countries in Eastern and Southern Africa," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-13, March.
    3. Dick Durevall & Annika Lindskog, 2016. "Adult Mortality, AIDS, and Fertility in Rural Malawi," The Developing Economies, Institute of Developing Economies, vol. 54(3), pages 215-242, September.
    4. 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.
    5. Akachi, Yoko & Canning, David, 2010. "Health trends in Sub-Saharan Africa: Conflicting evidence from infant mortality rates and adult heights," Economics & Human Biology, Elsevier, vol. 8(2), pages 273-288, July.
    6. Durevall, Dick & Lindskog, Annika, 2009. "How Does Communal HIV/AIDS Affect Fertility? - Evidence from Malawi," Working Papers in Economics 369, University of Gothenburg, Department of Economics, revised 25 Aug 2009.
    7. Mojola, Sanyu A., 2011. "Fishing in dangerous waters: Ecology, gender and economy in HIV risk," Social Science & Medicine, Elsevier, vol. 72(2), pages 149-156, January.

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