DP12192 Sex and the Mission: The Conflicting Effects of Early Christian Investments on the HIV Epidemic in sub-Saharan Africa

Author(s): Julia Cagé, Valeria Rueda
Publication Date: July 2017
Keyword(s): health investments, historical persistence, HIV/AIDS, missions, sexual behavior
JEL(s): D72, N37, N77, O33, Z12, Z13
Programme Areas: Public Economics, Economic History
Link to this Page: www.cepr.org/active/publications/discussion_papers/dp.php?dpno=12192

This article investigates the long-term historical impact of missionary activity on the prevalence of HIV/AIDS in sub-Saharan Africa. On the one hand, missionaries were the first to invest in modern medicine in a number of countries. On the other hand, the Christian influence on norms may have affected sexual beliefs and behaviors. We built a new geocoded dataset locating Protestant and Catholic missions in the early 20th century, as well as their health investments. We show that missionary presence has conflicting effects on HIV today. Regions close to historical mission stations exhibit higher HIV prevalence. This higher prevalence is robust to multiple specifications accounting for urbanization. Less knowledge about condom use is a likely channel. Moreover, among regions historically close to missionary settlements, proximity to a mission with a health investment is associated with lower HIV prevalence. Safer sexual behaviors around missions with health investments are a possible explanatory channel.