Are Africans Practicing Safer Sex? Evidence from Demographic and Health Surveys for Eight Countries
- 1 January 2008
- journal article
- research article
- Published by University of Chicago Press in Economic Development and Cultural Change
- Vol. 56 (2), 397-439
- https://doi.org/10.1086/522893
Abstract
We use repeated rounds of Demographic and Health Survey data from eight African countries to examine changes in and determinants of three HIV risk behaviors: age at first intercourse, number of current sexual partners, and use of condoms. As a prelude, we assess the within‐country comparability of DHS surveys over time. We find some evidence of changes in sample composition, which is easily handled in a multivariate framework. More problematic is evidence that people may be changing how they respond to questions about HIV behavior. This likely represents an increase in social desirability bias over time, and where it occurs our estimates of risk reduction are probably upper bounds on the true effects. Overall the picture is one of reductions in risk behaviors over recent 4–6‐year intervals, especially with respect to condom use; in some cases the changes seem large given the short time periods involved. With some exceptions, however, the extent and pervasiveness of these changes seems inadequate in relation to the urgency of the public health crisis represented by AIDS. With respect to the determinants of behaviors, schooling and wealth have contradictory impacts on risk behavior: they tend to increase the likelihood of using condoms while also (for men) increasing the demand for additional sexual partners.Keywords
This publication has 20 references indexed in Scilit:
- Uganda's HIV Prevention Success: The Role of Sexual Behavior Change and the National ResponseAIDS and Behavior, 2006
- Declines in HIV prevalence can be associated with changing sexual behaviour in Uganda, urban Kenya, Zimbabwe, and urban HaitiSexually Transmitted Infections, 2006
- Evidence for population level declines in adult HIV prevalence in KenyaSexually Transmitted Infections, 2006
- Scaling Up HIV Voluntary Counseling and Testing in AfricaEvaluation Review, 2005
- The HIV Epidemic in Four African Countries Seen through the Demographic and Health SurveysJournal of African Economies, 2005
- Age at first sex: understanding recent trends in African demographic surveysSexually Transmitted Infections, 2004
- Condom Promotion for AIDS Prevention in the Developing World: Is It Working?Studies in Family Planning, 2004
- The Balance of Self-Reported Heterosexual Activity in KAP Surveys and the AIDS Epidemic in AfricaJournal of the American Statistical Association, 1998
- Couple communication, sexual coercion, and HIV risk reduction in Kigali, RwandaAIDS, 1995
- African women and AIDS: Negotiating behavioral changeSocial Science & Medicine (1982), 1992