International Journal of Public Health

, Volume 58, Issue 2, pp 285–293 | Cite as

Multilateral, regional, and national determinants of policy adoption: the case of HIV/AIDS legislative action

  • Benjamin Y. ClarkEmail author
Original Article



This article examines the global legislative response to the HIV/AIDS epidemic with a particular focus on how policies were diffused internationally or regionally, or facilitated internally.


This article uses event history analysis combined with multinomial logit regression to model the legislative response of 133 countries.


First, the results demonstrate that the WHO positively influenced the likelihood of a legislative response. Second, the article demonstrates that development bank aid helped to spur earlier legislative action. Third, the results demonstrate that developed countries acted earlier than developing countries. And finally, the onset and severity of the HIV/AIDS epidemic was a significant influence on the legislative response.


Multilateral organizations have a positive influence in global policy diffusion through informational advocacy, technical assistance, and financial aid. It is also clear that internal stressors play key roles in legislative action seen clearly through earlier action being taken in countries where the shock of the onset of HIV/AIDS occurred earlier and earlier responses taken where the epidemic was more severe.


Multilateral organizations HIV/AIDS Policy process Event history analysis Policy diffusion 



I would like to thank Dineke Zeegers Paget, Executive Director at European Public Health Association, for providing me with the invaluable data that allowed me to complete this project. I would also like to thank my research assistant Jennifer Koperdak for her assistance on this article.


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Copyright information

© Swiss School of Public Health 2012

Authors and Affiliations

  1. 1.Levin College of Urban AffairsCleveland State UniversityClevelandUSA

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