0
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Trading HIV for sheep: Risky sexual behavior and the response of female sex workers to Tabaski in Senegal

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          We use a cohort of female sex workers (FSWs) in Senegal to show how large anticipated economic shocks lead to increased risky sexual behavior. Exploiting the exogenous timing of interviews, we study the effect of Tabaski, the most important Islamic festival celebrated in Senegal, in which most households purchase an expensive animal for sacrifice. Condom use, measured robustly via the list experiment, falls by between 27.3 percentage points (pp) (65.5%) and 43.1 pp (22.7%) in the 9 days before Tabaski, or a maximum of 49.5 pp (76%) in the 7 day period preceding Tabaski. The evidence suggests the economic pressures from Tabaski are key to driving the behavior change observed through the price premium for condomless sex. Those most exposed to the economic pressure from Tabaski were unlikely to be using condoms at all in the week before the festival. Our findings show that Tabaski leads to increased risky behaviors for FSWs, a key population at high risk of HIV infection, for at least 1 week every year and has implications for FSWs in all countries celebrating Tabaski or similar festivals. Because of the scale, frequency, and size of the behavioral response to shocks of this type, policy should be carefully designed to protect vulnerable women against anticipated shocks.

          Related collections

          Most cited references57

          • Record: found
          • Abstract: not found
          • Article: not found

          Determinants of social desirability bias in sensitive surveys: a literature review

            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Household catastrophic health expenditure: a multicountry analysis.

            Health policy makers have long been concerned with protecting people from the possibility that ill health will lead to catastrophic financial payments and subsequent impoverishment. Yet catastrophic expenditure is not rare. We investigated the extent of catastrophic health expenditure as a first step to developing appropriate policy responses. We used a cross-country analysis design. Data from household surveys in 59 countries were used to explore, by regression analysis, variables associated with catastrophic health expenditure. We defined expenditure as being catastrophic if a household's financial contributions to the health system exceed 40% of income remaining after subsistence needs have been met. The proportion of households facing catastrophic payments from out-of-pocket health expenses varied widely between countries. Catastrophic spending rates were highest in some countries in transition, and in certain Latin American countries. Three key preconditions for catastrophic payments were identified: the availability of health services requiring payment, low capacity to pay, and the lack of prepayment or health insurance. People, particularly in poor households, can be protected from catastrophic health expenditures by reducing a health system's reliance on out-of-pocket payments and providing more financial risk protection. Increase in the availability of health services is critical to improving health in poor countries, but this approach could raise the proportion of households facing catastrophic expenditure; risk protection policies would be especially important in this situation.
              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              The Economic Lives of the Poor.

                Bookmark

                Author and article information

                Contributors
                Henry.Cust@lshtm.ac.uk
                Journal
                Health Econ
                Health Econ
                10.1002/(ISSN)1099-1050
                HEC
                Health Economics
                John Wiley and Sons Inc. (Hoboken )
                1057-9230
                1099-1050
                02 November 2023
                January 2024
                : 33
                : 1 ( doiID: 10.1002/hec.v33.1 )
                : 153-193
                Affiliations
                [ 1 ] Global Health Economics Centre London School of Hygiene and Tropical Medicine London UK
                [ 2 ] University College London Institute for Global Health London UK
                [ 3 ] University Grenoble Alpes CNRS, INRAE Grenoble INP GAEL Grenoble France
                [ 4 ] Bayes Business School, City University of London London UK
                [ 5 ] Division de Lutte contre le Sida et les IST Institut d'hygiène Sociale Dakar Senegal
                Author notes
                [*] [* ] Correspondence

                Henry Cust.

                Email: Henry.Cust@ 123456lshtm.ac.uk

                Author information
                https://orcid.org/0000-0002-4868-5729
                Article
                HEC4756
                10.1002/hec.4756
                10952657
                37916862
                c8074077-7933-4e6e-9efd-ee8cfde4f795
                © 2023 The Authors. Health Economics published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 31 August 2023
                : 27 February 2023
                : 02 September 2023
                Page count
                Figures: 8, Tables: 22, Pages: 0, Words: 22539
                Funding
                Funded by: Medical Research Council , doi 10.13039/501100000265;
                Funded by: Bloomsbury colleges
                Categories
                O12
                I12
                I15
                D14
                Research Article
                Research Articles
                Custom metadata
                2.0
                January 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.3.9 mode:remove_FC converted:20.03.2024

                Economics of health & social care
                condomless sex,economic shocks,female sex workers,hiv,risky sexual behavior,tabaski

                Comments

                Comment on this article