Sex and the mission: the conflicting effects of early Christian missions on HIV in sub-Saharan Africa

This paper investigates the long-term impact of historical missionary activity on HIV in sub-Saharan Africa. On the one hand, missionaries were the first to invest in modern medicine in the region. On the other hand, Christianity influenced sexual beliefs and behaviors that affect the risk of contag...

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Bibliographic Details
Published in:Bulletin de l'Institut de recherches économiques et sociales 2020-09, Vol.86 (3), p.213-257
Main Authors: Cagé, Julia, Rueda, Valeria
Format: Article
Language:English
Subjects:
20th century
Biomarkers
Catholics
Christianity
Christians
Contagion
Datasets
Economics and Finance
Health care
Health facilities
Health services
Health surveys
HIV
Human immunodeficiency virus
Humanities and Social Sciences
Individual differences
Medicine
Missionaries
Monogamy
Population
Proximity
Public health
Religious conversion
Religious missions
Research Papers
Risk behavior
Safe sexual practices
Sexual behavior
Sexual beliefs
Sexually transmitted diseases
STD
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Summary:This paper investigates the long-term impact of historical missionary activity on HIV in sub-Saharan Africa. On the one hand, missionaries were the first to invest in modern medicine in the region. On the other hand, Christianity influenced sexual beliefs and behaviors that affect the risk of contagion. We build a new geocoded dataset locating Protestant and Catholic missions in the early 20th century, as well as the health facilities they invested in, that we combine with individual-level Demographic and Health Survey data. With these data, we can address separately these two channels, within regions close to historical missionary settlements. First, we show that proximity to historical missionary health facilities decreases the likelihood of HIV; persistence in healthcare provision and safer sexual behaviors in the region explain this result. Second, we show that regions close to historical missionary settlements exhibit higher likelihood of HIV. This effect is driven by the Christian population in our sample. This suggests conversion to Christianity as a possible explanatory channel. Our findings are robust to alternative specifications addressing selection.
ISSN:2054-0892
1373-9719
2054-0906
DOI:10.1017/dem.2019.16