Poverty, Sex and HIV
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- Nattrass, N. AIDS Behav (2009) 13: 833. doi:10.1007/s10461-009-9563-9
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There is an ongoing debate about the relative importance of economic factors (notably poverty) and sexual behavior in driving the AIDS epidemic. This paper draws on relevant research and cross-country regression analysis to argue that the impact of economic determinants is dwarfed by contextual factors within Africa. The regression analysis suggests that controlling for per capita income, calories per capita and the ratio of female to male participation rates (none of which were statistically significant): being a Southern African country increases expected HIV prevalence 8.3 times; being in the rest of Sub-Saharan Africa 3 times; being a predominantly Protestant country 2.5 times; and being a predominantly Muslim country reduces expected HIV prevalence to 62% of the base case. Including the share of income going to the poor did not improve the model and was itself statistically insignificant. The analysis suggests that poverty may play a role in the HIV epidemic in some countries (and may well be a factor affecting the vulnerability of some people to HIV infection in all countries) but that its overall impact is dwarfed by social and behavioral factors.