We study the relationship between education and HIV status using nationally representative data from 39 Demographic and Health Surveys (DHS) in Sub-Saharan Africa. First, we construct an innovative algorithm that systematically defines aggregate stages of the HIV epidemic in a comparable manner across time and across space. Second, we exploit the variation in the aggregate HIV stages in the DHS data, and find that the education gradient in HIV shows a U-shaped (positive-zero-positive) pattern over the course of the epidemic. Further, educational disparities in the number of extramarital partners are largely consistent with the evolution of the education gradient in HIV. We propose a simple theoretical model of risky sex choices that accounts for these stylized facts.
{"title":"Education, HIV Status and Risky Sexual Behavior: How Much Does the Stage of the HIV Epidemic Matter?","authors":"D. Iorio, Raül Santaeulàlia-Llopis","doi":"10.2139/ssrn.2820991","DOIUrl":"https://doi.org/10.2139/ssrn.2820991","url":null,"abstract":"We study the relationship between education and HIV status using nationally representative data from 39 Demographic and Health Surveys (DHS) in Sub-Saharan Africa. First, we construct an innovative algorithm that systematically defines aggregate stages of the HIV epidemic in a comparable manner across time and across space. Second, we exploit the variation in the aggregate HIV stages in the DHS data, and find that the education gradient in HIV shows a U-shaped (positive-zero-positive) pattern over the course of the epidemic. Further, educational disparities in the number of extramarital partners are largely consistent with the evolution of the education gradient in HIV. We propose a simple theoretical model of risky sex choices that accounts for these stylized facts.","PeriodicalId":423959,"journal":{"name":"MedRN: HIV/AIDS (Topic)","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129049126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The potential epidemiological impact of preventive HIV vaccines on the HIV epidemic in Southern India is examined using a mathematical deterministic dynamic compartmental model. Various assumptions about the degree of protection offered by such a vaccine, the extent of immunological response of those vaccinated, and the duration of protection afforded are explored. Alternative targeting strategies for HIV vaccination are simulated and compared with the impact of conventional prevention interventions in high-risk groups and the general population. The impact of disinhibition (increased risk behavior due to the presence of a vaccine) is also considered. Vaccines that convey a high degree of protection in a share of or all of those immunized and that convey life-long immunity are the most effective in curbing the HIV epidemic. Vaccines that convey less than complete protection may also have substantial public health impact, but disinhibition can easily undo their effects and they should be used combined with conventional prevention efforts. Conventional interventions that target commercial sex workers and their clients to increase condom use can also be highly effective and can be implemented immediately, before the arrival of vaccines.
{"title":"The Epidemiological Impact of an HIV Vaccine on the Hiv/Aids Epidemic in Southern India","authors":"N. Nagelkerke, S. D. de Vlas","doi":"10.1596/1813-9450-2978","DOIUrl":"https://doi.org/10.1596/1813-9450-2978","url":null,"abstract":"The potential epidemiological impact of preventive HIV vaccines on the HIV epidemic in Southern India is examined using a mathematical deterministic dynamic compartmental model. Various assumptions about the degree of protection offered by such a vaccine, the extent of immunological response of those vaccinated, and the duration of protection afforded are explored. Alternative targeting strategies for HIV vaccination are simulated and compared with the impact of conventional prevention interventions in high-risk groups and the general population. The impact of disinhibition (increased risk behavior due to the presence of a vaccine) is also considered. Vaccines that convey a high degree of protection in a share of or all of those immunized and that convey life-long immunity are the most effective in curbing the HIV epidemic. Vaccines that convey less than complete protection may also have substantial public health impact, but disinhibition can easily undo their effects and they should be used combined with conventional prevention efforts. Conventional interventions that target commercial sex workers and their clients to increase condom use can also be highly effective and can be implemented immediately, before the arrival of vaccines.","PeriodicalId":423959,"journal":{"name":"MedRN: HIV/AIDS (Topic)","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2003-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128541660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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