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Demographic consequences of HIV


In this study, we estimate the effect of the HIV epidemic on demographic outcomes in three countries in Sub-Saharan Africa. We apply the synthetic control group method and estimate the consequences for life expectancy, mortality, and birth rates. According to standard measures of fit, the method seems to perform well for all countries and outcomes. Our results show a large effect on life expectancy and mortality in two countries, and a small and insignificant effect on birth rates. The impact of the pandemic is very heterogeneous. In Mozambique, the impact of HIV on life expectancy and mortality appears to have been surprisingly small. This heterogeneity is not due to AIDS causing fewer deaths in Mozambique than in the two other countries. Instead, the net effect of HIV in Mozambique appears to be diminished by reduced mortality for other causes—in particular child mortality, respiratory infections, and injuries.

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  1. Several later studies—such as Kalemli-Ozcan (2012)—rebut the main result of Young (2005). However, in this paper, we combine the analysis with other demographic variables in order to obtain a deeper understanding of the processes.

  2. Bell et al. (2006) consider a similar threshold to determine the start of the pandemic.

  3. A multiple testing problem also arises due to the inclusion of three distinct outcome variables. We ignore this problem here, but it will become clear that it does not affect our conclusions.

  4. Abadie et al. (2010) obtain a value of around 2.8–5.1 % in their analysis, while Hinrichs (2012) and Montalvo (2011) report even larger discrepancies.

  5. The availability of antiretroviral drugs is likely to have reduced these rates significantly in recent years (Rollins et al. 2013).


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We would like to thank Emily Oster for making HIV prevalence data available. Moreover, we thank Annika Lindskog for excellent comments and Christian Brückner for research assistance. Finally, we thank two anonymous referees for their help and guidance. We take responsibility for all remaining errors in and shortcomings of the article.

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Correspondence to Stefan Pichler.

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Karlsson, M., Pichler, S. Demographic consequences of HIV. J Popul Econ 28, 1097–1135 (2015).

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  • HIV
  • AIDS
  • Mortality
  • Life expectancy
  • Fertility
  • Synthetic control groups

JEL Classification

  • I15
  • J11
  • O15.