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Why did HIV decline in Uganda?

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  • Marcella M. Alsan
  • David M. Cutler

Abstract

Uganda is widely viewed as a public health success for curtailing its HIV/AIDS epidemic in the early 1990s. We investigate the factors contributing to this decline. We first build a model of HIV transmission. Calibration of the model indicates that reduced pre-marital sexual activity among young women is the most important factor in the decline in HIV. We next explore what led young women to change their behavior. We estimate that approximately one-third the reduction in HIV in this cohort and almost 20 percent of the overall HIV decline was due to a gender-targeted education policy.

Suggested Citation

  • Marcella M. Alsan & David M. Cutler, 2010. "Why did HIV decline in Uganda?," NBER Working Papers 16171, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:16171
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    1. Philipson, Tomas, 2000. "Economic epidemiology and infectious diseases," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 33, pages 1761-1799, Elsevier.
    2. Brooke Grundfest Schoepf, 2003. "Uganda: lessons for aids control in Africa," Review of African Political Economy, Taylor & Francis Journals, vol. 30(98), pages 553-572, December.
    3. Gysels, Marjolein & Pool, Robert & Nnalusiba, Betty, 2002. "Women who sell sex in a Ugandan trading town: life histories, survival strategies and risk," Social Science & Medicine, Elsevier, vol. 54(2), pages 179-192, January.
    4. Sarah Baird & Ephraim Chirwa & Craig McIntosh & Berk Özler, 2010. "The short‐term impacts of a schooling conditional cash transfer program on the sexual behavior of young women," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 55-68, September.
    5. Ainsworth, Martha & Beyrer, Chris & Soucat, Agnes, 2003. "AIDS and public policy: the lessons and challenges of `success' in Thailand," Health Policy, Elsevier, vol. 64(1), pages 13-37, April.
    6. Paul M. Sharp & Beatrice H. Hahn, 2008. "Prehistory of HIV-1," Nature, Nature, vol. 455(7213), pages 605-606, October.
    7. Chinhui Juhn & Sebnem Kalemli-Ozcan & Belgi Turan, 2013. "HIV and fertility in Africa: first evidence from population-based surveys," Journal of Population Economics, Springer;European Society for Population Economics, vol. 26(3), pages 835-853, July.
    8. 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.
    9. Parkhurst, Justin O & Lush, Louisiana, 2004. "The political environment of HIV: lessons from a comparison of Uganda and South Africa," Social Science & Medicine, Elsevier, vol. 59(9), pages 1913-1924, November.
    10. 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.
    11. Anne Case & Christina Paxson, 2011. "The Impact of the AIDS Pandemic on Health Services in Africa: Evidence from Demographic and Health Surveys," Demography, Springer;Population Association of America (PAA), vol. 48(2), pages 675-697, May.
    12. Sarah Baird & Ephraim Chirwa & Craig McIntosh & Berk Ozler, 2009. "The Short-Term Impacts of as Schooling Cash Transfer Program on the Sexual Behavior of Young Women," Working Papers 2010-10, The George Washington University, Institute for International Economic Policy.
    13. Alwyn Young, 2007. "In sorrow to bring forth children: fertility amidst the plague of HIV," Journal of Economic Growth, Springer, vol. 12(4), pages 283-327, December.
    14. Anne Case & Christina Paxson, 2009. "The impact of the AIDS pandemic on health services in Africa: Evidence from Demographic Health Surveys," Working Papers 1139, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies..
    15. Pauline M. Leclerc & Michel Garenne, 2007. "Inconsistencies in age profiles of HIV prevalence," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 16(5), pages 121-140.
    16. Michael Worobey & Marlea Gemmel & Dirk E. Teuwen & Tamara Haselkorn & Kevin Kunstman & Michael Bunce & Jean-Jacques Muyembe & Jean-Marie M. Kabongo & Raphaël M. Kalengayi & Eric Van Marck & M. Thomas , 2008. "Direct evidence of extensive diversity of HIV-1 in Kinshasa by 1960," Nature, Nature, vol. 455(7213), pages 661-664, October.
    17. repec:pri:rpdevs:case%20paxson%20the%20impact%20of%20the%20aids%20pandemic%20march%206 is not listed on IDEAS
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    Cited by:

    1. Cagé, Julia & Rueda, Valeria, 2020. "Sex and the mission: the conflicting effects of early Christian missions on HIV in sub-Saharan Africa," Journal of Demographic Economics, Cambridge University Press, vol. 86(3), pages 213-257, September.
    2. repec:hal:spmain:info:hdl:2441/76npisrda99aop75h6fmi4vduu is not listed on IDEAS
    3. repec:spo:wpecon:info:hdl:2441/76npisrda99aop75h6fmi4vduu is not listed on IDEAS
    4. repec:spo:wpmain:info:hdl:2441/76npisrda99aop75h6fmi4vduu is not listed on IDEAS
    5. repec:hal:wpspec:info:hdl:2441/76npisrda99aop75h6fmi4vduu is not listed on IDEAS
    6. Alsan, Marcella M. & Cutler, David M., 2013. "Girls’ education and HIV risk: Evidence from Uganda," Journal of Health Economics, Elsevier, vol. 32(5), pages 863-872.
    7. Julia Cage & Valeria Rueda, 2017. "Sex and the Mission: The Conflicting Effects of Early Christian Investments on the HIV Epidemic in sub-Saharan Africa," SciencePo Working papers Main hal-03393166, HAL.

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    More about this item

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • O55 - Economic Development, Innovation, Technological Change, and Growth - - Economywide Country Studies - - - Africa

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