Suchergebnisse

Most analyses of the determinants of HIV infection are performed at the individual level. The recent Demographic and Health Surveys, which include results from HIV tests, allow the study of HIV infection at the level of the cohabiting couple. This article exploits this feature of the data for Burkina Faso, Cameroon, Ghana, Kenya, and Tanzania. The analysis yields two findings about the dynamics of the HIV/AIDS epidemic that have important implications for policy. First, at least two‐thirds of the infected couples are sero‐discordant, that is, only one of the two partners is infected. This implies scope for prevention efforts among infected couples. Second, among 30–40 percent of the infected couples only the woman is infected. This is at odds with levels of self‐reported extramarital sex by women and with the common perception that unfaithful men are the main link between high‐risk groups and the general population. These findings are confirmed by tests of robustness. These results indicate that extramarital sexual activity among women in union is a substantial source of vulnerability to HIV that should be, as much as male extramarital activity, targeted by prevention efforts.

To examine the impact of Rwandaś 1994 genocide on childrenś schooling, the authors combine two cross-sectional household surveys collected before and after the genocide. The identification strategy uses pre-war data to control for an age groupś baseline schooling and exploits variation across provinces in the intensity of killings and which childrenś cohorts were school-aged when exposed to the war. The findings show a strong negative impact of the genocide on schooling, with exposed children completing one-half year less education representing an 18.3 percent decline. The effect is robust to including control variables, alternative sources for genocide intensity, and an instrumental variables strategy. -- Civil war ; human capital investment ; education ; genocide ; Africa

We combine data from 84 Demographic and Health Surveys from 46 countries to analyze trends and socioeconomic differences in adult mortality, calculating mortality based on the sibling mortality reports collected from female respondents aged 15–49. The analysis yields four main findings. First, adult mortality is different from child mortality: while under‐5 mortality shows a definite improving trend over time, adult mortality does not, especially in sub‐Saharan Africa. The second main finding is the increase in adult mortality in sub‐Saharan African countries. The increase is dramatic among those most affected by the HIV/AIDS pandemic. Mortality rates in the highest HIV‐prevalence countries of southern Africa exceed those in countries that experienced episodes of armed conflict. Third, even in sub‐Saharan countries where HIV prevalence is not as high, mortality rates appear to be at best stagnating, and even increasing in several cases. Finally, the main dimension along which mortality appears to differ in the aggregate is by sex. Adult mortality rates in sub‐Saharan Africa have risen substantially higher for men than for women—especially so in the high HIV‐prevalence countries. On the whole, the data do not show large gaps by urban/rural residence or by school attainment.

Separated, divorced, and widowed individuals in Africa are at significantly increased risk for HIV infection. Using nationally representative data from 13 sub‐Saharan African countries, this study confirms that finding and goes further by examining those who have experienced a marital dissolution and are now remarried. Results show that remarried individuals form a large portion of the population and have a higher‐than‐average HIV prevalence. HIV‐positive remarried individuals are at risk of transmitting the infection to their spouse, because many of the couples are serodiscordant. The large number of high‐risk remarried individuals is a source of vulnerability and further infection, and should be acknowledged and taken into account by prevention strategies that rarely address this population.