Mobile Phones and HIV Testing: Multicountry Instrumental Variable Analysis From Sub-Saharan Africa (Preprint)

Abstract

UNSTRUCTURED This study investigates the role of mobile phone connectivity on HIV testing in sub-Saharan Africa. We make use of the novel and comprehensive OpencellID cell tower database, and DHS geocoded information for over 400,000 women in 28 Sub-Saharan African countries. We examine whether women’s community distance from the closest cell-tower influences knowledge about HIV testing facilities and the likelihood of ever been tested for HIV. After finding a negative and significant impact of distance on our main outcomes, we investigate the mechanisms through which such effects might occur. Our analysis shows that proximity to a cell tower increases HIV-related knowledge as well as reproductive health knowledge. Similar results are observed when the analysis is performed at community level. Results suggest that the effect of mobile phone connectivity is channelled through increased knowledge of HIV, STIs, and modern contraceptive methods. Further analysis shows that cell phone ownership has an even larger impact on HIV testing and knowledge. This paper adds to recent literature on the impact of mobile-based HIV prevention schemes by showing through large-scale analysis that better mobile network access is a powerful tool to spread reproductive health knowledge and increase HIV awareness.