Inequality and Economic Inclusion

Changes in HIV/AIDS knowledge and testing behavior in Africa: How much and for whom?

  • Year: 2004
  • Publication Author(s): Peter Glick; David Sahn
  • Countries and Regions: South Africa

AIDS has had its most devastating impacts in Africa and the prevalence of the disease continues to rise in most African countries. With a feasible vaccine still years away, reduction in risk behaviors remains the only way to reverse the epidemic. An obvious prerequisite for behavior change is that people have an understanding of the disease and how infection can be averted. Several studies have looked at the determinants of HIV risk behaviors in Africa (Filmer 1998, Blanc 2000), but analysis of the factors determining knowledge of means of HIV prevention is less common.

Further, the studies that have been carried out to date have been cross sectional analyses. In this paper in contrast we consider the all important issue of changes over time in HIV prevention knowledge as well as in HIV testing behavior and attitudes toward testing. We do this by taking advantage of the fact that there are now a number of African countries in which more than one round of Demographic and Health Surveys (DHSs) with comparable HIV-related information has been carried out. We examine changes in these outcomes in Burkina Faso, Kenya, Tanzania, Uganda, and Zambia over periods of 3 to 6 years during the mid to late 90s and early 00s, as dictated by the survey years. In addition we ask how changes in knowledge and testing behavior are distributed across the distributions of schooling and household income as well as by gender and rural vs. urban location. We address this question descriptively and econometrically, the latter by estimating and comparing statistically HIV knowledge ‘returns’ to schooling, wealth, and age in early and later survey years.