title: HIV and sexual behavior change: why not Africa?
abstract: 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.
authors.affiliation: University of Chicago and NBER, United States. emily.oster@chicagobooth.edu
authors.forename: Emily
authors.initials: E
authors.lastname: Oster
mesh_terms: D017954:Africa South of the Sahara / Q000453:epidemiology; D015982:Bias; D015658:HIV Infections / Q000453:epidemiology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016018:Least-Squares Analysis; D008017:Life Expectancy; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology*