Effects of Household Shocks and Poverty on the Timing of Traditional Male Circumcision and HIV Risk in South Africa
Poverty may influence HIV risk by increasing vulnerability to economic shocks and thereby preventing key health investments. We explored this possibility by examining the relationship between household shocks and the timing of traditional male circumcision, a practice associated with considerable expense and whose HIV-prevention benefits are larger when done earlier, even within young adulthood. Using unique data on a sample of Xhosa men, a group that almost universally practices traditional circumcision, we found that respondents in the poorest households delayed circumcision by 2 years if a household member experienced loss of income or death and/or illness. The impact of these shocks declined with increasing household income. Our findings suggest that interventions that work to mitigate the impact of shocks among the poor may be useful in HIV prevention efforts. More generally, they illustrate that the relationship between HIV and wealth may be more nuanced than assumed in previous work.
KeywordsEconomic shocks Poverty Male circumcision HIV South Africa
- 6.Burke M, Gong E, Jones K. Income shocks and HIV in Africa. Berkeley: Mimeo, University of California; 2012.Google Scholar
- 8.Morduch J. Poverty and vulnerability. Am Econ Rev. 1994;84(2):221–5.Google Scholar
- 12.Majaja M, Setswe G, Peltzer K, Matseke G, Phawani K. Perceptions and acceptability of male circumcision (MC) in South Africa: a qualitative study. Vienna: XVIII International AIDS Conference; 2010. abstract MOPE0658.Google Scholar
- 15.Case A, Menendez A. Requiescat in pace? The consequences of high priced funerals in South Africa. NBER Working Paper No. 14998; 2009.Google Scholar
- 18.Dupas P, Robinson J. Why don’t the poor save more? Evidence from health savings experiments. NBER Working Paper No. 17255; 2011.Google Scholar
- 24.Sabet Sarvestani A, Bufumbo L, Geiger J, Sienko K. Traditional male circumcision in Uganda: a qualitative focus group discussion analysis. PLoS One. 2012;7(10):e45316. doi:10.1371/journal.pone.0045316.
- 25.Chinkhumba J, Godlonton S, Thornton R. Demand for medical male circumcision. Ann Arbor: Mimeo, University of Michigan; 2012.Google Scholar