HIV and Sexual Behavior Change: Why Not Africa?

Emily Oster

NBER Working Paper No. 13049
Issued in April 2007
NBER Program(s):   HE   LS

The response of sexual behavior to HIV in Africa is an important input to predicting the path of the epidemic and to focusing prevention efforts. Existing estimates suggest limited behavioral response, but fail to take into account possible differences across individuals. A simple model of sexual behavior choice among forward-looking individuals implies that behavioral response should be larger for those with lower non-HIV mortality risks and those who are richer. I estimate behavioral response using a new instrumental variables strategy, instrumenting for HIV prevalence with distance to the origin of the virus. I find low response on average, consistent with existing literature, but larger responses for those who face lower non-HIV mortality and for those who are richer. I also show suggestive evidence, based on a very simple calibration, that the magnitude of behavioral response in Africa is of a similar order of magnitude to that among gay men in the United States, once differences in income and life expectancy are taken into account.

download in pdf format
   (395 K)

email paper

The NBER Bulletin on Aging and Health provides summaries of publications like this.  You can sign up to receive the NBER Bulletin on Aging and Health by email.

Supplementary materials for this paper:

Machine-readable bibliographic record - MARC, RIS, BibTeX

Document Object Identifier (DOI): 10.3386/w13049

Published: “HIV and Sexual Behavior Change: Why Not Africa?” Journal of Health Economics, Volume 31, Issue 1, January 2012, Pages 35–49 citation courtesy of

Users who downloaded this paper also downloaded these:
Oster w13610 Routes of Infection: Exports and HIV Incidence in Sub-Saharan Africa
Philipson w7037 Economic Epidemiology and Infectious Diseases
Jayachandran and Lleras-Muney w13947 Life Expectancy and Human Capital Investments: Evidence From Maternal Mortality Declines
Juhn, Kalemli-Ozcan, and Turan w14248 HIV and Fertility in Africa: First Evidence from Population Based Surveys
Jensen and Oster w13305 The Power of TV: Cable Television and Women's Status in India
NBER Videos

National Bureau of Economic Research, 1050 Massachusetts Ave., Cambridge, MA 02138; 617-868-3900; email:

Contact Us