Reproductive Health and Behavior, HIV/AIDS, and Poverty in Africa

Abstract

This paper examines the complex linkages of poverty, reproductive/sexual health and behavior, and HIV/AIDS in Africa. It addresses the following questions:(1) what have we learned to date about these links and what are the gaps in knowledge to be addressed by further research; (2) what is known about the effectiveness for HIV prevention of reproductive health and HIV/AIDS interventions and policies in Africa; and (3) what are the appropriate methodological approaches to research on these questions. With regard to what has been learned so far, the paper pays considerable attention in particular to the evidence regarding the impacts of a range of HIV interventions on risk behaviors and HIV incidence. Other sections review the extensive microeconomic literature on the impacts of AIDS on households and children in Africa and the effects of the epidemic on sexual risk behavior and fertility decisions. With regard to methodology, the paper assesses the approaches used in the literature to deal with, among other things, the problem of self-selection and nonrandomness in the placement of HIV and reproductive health programs. Data requirements for different research questions are discussed, and an effort is made to assess what researchers can learn from existing sources such as Demographic and Health Surveys.3

HIV/AIDS Sero‐prevalence and Socio‐economic Status: Evidence from Uganda

“…The HIV/AIDS literature identifies other predisposing and enabling factors that may fuel the spread of the disease. These are: the poor state of general reproductive health services that leads to a large burden of sexually transmitted infections (STIs); poorly developed health services—to the extent that a large proportion of the population do not know their HIV status; and biological factors (Anyanwu et al ., ; Oster, , ; Glick, ; Ferry et al , ). One of the most highlighted reproductive health characteristics of SSA is the large number of untreated non‐HIV STIs.…”

“…Other pathways to HIV infection relate to the state of overall health services. Glick () notes that the majority of the adult population in SSA has never been tested for HIV/AIDS despite the outbreak of the disease more than 30 years ago. Thus, there is limited knowledge about HIV/AIDS status, which exacerbates the spread of the disease, as mentioned earlier.…”

The Long-Run Impacts of Adult Deaths on Older Household Members in Tanzania

“…Certain individuals (and families) may be more likely to suffer an AIDS death. For example, poverty is often cited as a key driver of transmission of HIV/AIDS (Fenton 2004), although the evidence of this link tends to show the opposite association (as noted by Shelton, Cassell, and Adetunji 2005; Wojcicki 2005; Gillespie, Kadiyala, and Greener 2007; and Glick (2007). In their study of eight sub-Saharan African countries, Mishra et al (2007) find that wealthier adults are more likely to be infected with HIV, although this association is very weak after controlling for urban/rural residence and education.…”

The Impact of Violent Conflicts on Households: What Do We Know and What Should We Know about War Widows?

“…A general finding of this literature is that widows in Western societies are often vulnerable to poverty (Hurd & Wise, 1989McDonald et al, 2000;Weir & Willis, 2000). Another analysis of widows explores household dissolution and the role of widows in conjunction with the HIV/AIDS pandemic (Glick, 2007). HIV widows in five East and Southern African countries were found to be more vulnerable to poverty and land shortage than other households (Mather et al, 2004a), while widows have not been found to be worse-off in Mozambique (Mather et al, 2004b).…”