Protecting women from economic shock to fight HIV in Africa: Evidence from the POWER trial

Young women in Sub-Saharan Africa are disproportionately affected by the HIV epidemic: they are twice as likely to be living with HIV than men of the same age and account for 64% of new HIV infections among young people. Many studies suggest that financial needs, alongside biological susceptibility, are the main causes of the gender disparity in HIV acquisition. While the literature shows limited understanding of the link between poverty and HIV, there is some new robust evidence demonstrating that women adopt risky sexual behaviours as a way to cope with economic shocks. There are a number of reasons why economic shocks could lead to STIs and HIV acquisition. The main reason lies in the fact that the low access to formal well-paid jobs and productive assets make women in Africa prone to use commercial and transactional sex as risk-coping strategies. Such strategies may be attractive given that women can raise money quickly and earn up to three times more compared to other occupations. In addition, there is extensive literature showing a large positive premium for unprotected sex for women engaging in commercial sex. Determining whether economic shock is a missing piece of the HIV puzzle is critical since economic shocks are common and women do not currently have formal risk-coping strategies in Africa. In this presentation, I will present new evidence from the ongoing POWER randomised controlled trial in which we measure the effect of protecting women at high-risk of HIV as well as their economic dependents against illness shock on their likelihood of becoming infected with HIV.

Aurelia Lepine's Profile