Understanding the Southern African ‘Anomaly’: Poverty,Endemic Disease and HIV |
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| Authors: | Larry Sawers Eileen Stillwaggon |
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| Institution: | 1. is Professor of Economics at American University in Washington, DC and is the corresponding author;2. he can be contacted at lsawers@american.edu. His research interests are in the field of economic development and he has published books and articles on Argentina, Ecuador, Tanzania and Lithuania. His research in recent years has focused on the HIV epidemics in Africa.;3. is Professor of Economics and Harold G. Evans Eisenhower Professor at Gettysburg College in Pennsylvania. She has written a number of scholarly articles and books on poverty, health and development and on HIV epidemics in poor populations. |
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| Abstract: | The epicentre of the global HIV epidemic is southern Africa. Previous explanations point to migration patterns and highly skewed income distribution, both thought to promote risky sexual behaviour. This study emphasizes the importance of common infectious and parasitic diseases that increase the likelihood of HIV transmission by increasing contagiousness and vulnerability to infection. Using multiple regression analysis on country‐level data, the authors find that socio‐economic variables explain statistically only one‐tenth of the difference in HIV prevalence between southern Africa and other low‐ and middle‐income countries. Measures of five cofactor infections together with the socio‐economic variables, however, explain statistically about two‐thirds of the southern Africa difference in HIV prevalence. They conclude that the relative affluence of countries in southern Africa and historical migration patterns have tended to mask the vulnerability of the majority of their populations who are poor and who have very high prevalence of infectious and parasitic diseases. Those diseases replicate a cycle of poverty that produces biological vulnerability through coinfections. An important implication of this research is that integrating treatment of endemic diseases with other HIV‐prevention policies may be necessary to slow the spread of HIV. |
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