Why AIDS Is Worse in Africa
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As an economics student at Harvard, Emily Oster couldn’t figure out why no one in her field was working on HIV/AIDS—particularly what’s causing the epidemic in Africa—so she took up the topic herself. Now a research fellow at the Becker Center on Chicago Price Theory, she’s gotten some surprising results—and a lot of attention.
First, “it’s the wrong disease to attack,” Oster wrote in Esquire. Compared to Americans, Africans are four to five times more likely to contract HIV from unprotected intercourse with an HIV-positive person. Oster attributes this to higher instances of bacterial and viral STDs in Africans—nearly half carry the herpes virus—which make them more susceptible to HIV. Treating these other STDs, Oster says, could significantly reduce HIV transmission.
And while safe-sex education has changed sexual behavior in the United States, it’s had little effect in Africa, which Oster ascribes to quality-of-life differences. “How much people care about dying from AIDS 10 years from now depends on how many years they expect to live today and how enjoyable they expect those future years to be,” Oster wrote. “If income and life expectancy in Africa were the same as they are in the United States, we would see the same change in sexual behavior—and the AIDS epidemic would begin to slow.”
Finally, Oster used death rates to estimate the prevalence of AIDS in the general African population. She found that the popular UN estimates of African AIDS cases, which are based on tests of pregnant women at prenatal clinics, are about three times too high. However, Oster says, the news is not as good as it sounds. “My study, which estimated changes in the infection rate over time, also drew a second, chilling conclusion: In Africa, HIV is spreading as quickly as ever.”
In addition to the December Esquire article, Oster’s research on AIDS was featured in a January New York Times story on the future of economics.
