Different forms of household wealth are associated with opposing risks for HIV infection in East Africa

Craig Hadley, Amanda Maxfield, Daniel Hruschka

    Research output: Contribution to journalArticle

    1 Citation (Scopus)

    Abstract

    The relationship between material wealth and HIV infection in sub-Saharan Africa has been the subject of considerable debate in part because many studies show that wealth is positively associated with infection. Others have critiqued such results, suggesting that the widely used indicators of wealth underlying these results fail to capture the diversity of livelihood portfolios in East Africa. Using population representative data from 35,799 households in Kenya, Ethiopia, and Tanzania, we estimate household wealth along two different dimensions, associated respectively with success in wage economies and agricultural economies. Regression models for men and women show consistent and opposing associations between type of wealth and HIV infection. Controlling for age, education, and urban dwelling, increasing achievement along the wage economy dimension is positively (often significantly) associated with HIV infection. In contrast, increasing achievement along the agricultural economy dimension is often negatively associated with HIV infection, and is never associated with increased HIV risk. Interestingly, variables to assess risky sexual behaviors do not mediate the relationship between either type of wealth and HIV infection. Our results suggest that future studies on the relationship between HIV and wealth need to take into account the different dimensions of household wealth found in East African countries. Our results also generate new, important questions about why and how different forms of wealth drive HIV infection.

    Original languageEnglish (US)
    Pages (from-to)344-351
    Number of pages8
    JournalWorld Development
    Volume113
    DOIs
    StatePublished - Jan 1 2019

    Fingerprint

    East Africa
    human immunodeficiency virus
    wage
    agriculture
    economy
    Ethiopia
    Tanzania
    Kenya
    livelihood
    regression
    education
    sexual behavior
    infection
    household
    Household wealth
    HIV infection
    Wealth

    Keywords

    • Africa
    • HIV
    • Livelihoods
    • Social determinants of health
    • Wealth

    ASJC Scopus subject areas

    • Geography, Planning and Development
    • Development
    • Sociology and Political Science
    • Economics and Econometrics

    Cite this

    Different forms of household wealth are associated with opposing risks for HIV infection in East Africa. / Hadley, Craig; Maxfield, Amanda; Hruschka, Daniel.

    In: World Development, Vol. 113, 01.01.2019, p. 344-351.

    Research output: Contribution to journalArticle

    @article{248ae3d63b7849338378101c82ad521d,
    title = "Different forms of household wealth are associated with opposing risks for HIV infection in East Africa",
    abstract = "The relationship between material wealth and HIV infection in sub-Saharan Africa has been the subject of considerable debate in part because many studies show that wealth is positively associated with infection. Others have critiqued such results, suggesting that the widely used indicators of wealth underlying these results fail to capture the diversity of livelihood portfolios in East Africa. Using population representative data from 35,799 households in Kenya, Ethiopia, and Tanzania, we estimate household wealth along two different dimensions, associated respectively with success in wage economies and agricultural economies. Regression models for men and women show consistent and opposing associations between type of wealth and HIV infection. Controlling for age, education, and urban dwelling, increasing achievement along the wage economy dimension is positively (often significantly) associated with HIV infection. In contrast, increasing achievement along the agricultural economy dimension is often negatively associated with HIV infection, and is never associated with increased HIV risk. Interestingly, variables to assess risky sexual behaviors do not mediate the relationship between either type of wealth and HIV infection. Our results suggest that future studies on the relationship between HIV and wealth need to take into account the different dimensions of household wealth found in East African countries. Our results also generate new, important questions about why and how different forms of wealth drive HIV infection.",
    keywords = "Africa, HIV, Livelihoods, Social determinants of health, Wealth",
    author = "Craig Hadley and Amanda Maxfield and Daniel Hruschka",
    year = "2019",
    month = "1",
    day = "1",
    doi = "10.1016/j.worlddev.2018.09.015",
    language = "English (US)",
    volume = "113",
    pages = "344--351",
    journal = "World Development",
    issn = "1873-5991",
    publisher = "Elsevier BV",

    }

    TY - JOUR

    T1 - Different forms of household wealth are associated with opposing risks for HIV infection in East Africa

    AU - Hadley, Craig

    AU - Maxfield, Amanda

    AU - Hruschka, Daniel

    PY - 2019/1/1

    Y1 - 2019/1/1

    N2 - The relationship between material wealth and HIV infection in sub-Saharan Africa has been the subject of considerable debate in part because many studies show that wealth is positively associated with infection. Others have critiqued such results, suggesting that the widely used indicators of wealth underlying these results fail to capture the diversity of livelihood portfolios in East Africa. Using population representative data from 35,799 households in Kenya, Ethiopia, and Tanzania, we estimate household wealth along two different dimensions, associated respectively with success in wage economies and agricultural economies. Regression models for men and women show consistent and opposing associations between type of wealth and HIV infection. Controlling for age, education, and urban dwelling, increasing achievement along the wage economy dimension is positively (often significantly) associated with HIV infection. In contrast, increasing achievement along the agricultural economy dimension is often negatively associated with HIV infection, and is never associated with increased HIV risk. Interestingly, variables to assess risky sexual behaviors do not mediate the relationship between either type of wealth and HIV infection. Our results suggest that future studies on the relationship between HIV and wealth need to take into account the different dimensions of household wealth found in East African countries. Our results also generate new, important questions about why and how different forms of wealth drive HIV infection.

    AB - The relationship between material wealth and HIV infection in sub-Saharan Africa has been the subject of considerable debate in part because many studies show that wealth is positively associated with infection. Others have critiqued such results, suggesting that the widely used indicators of wealth underlying these results fail to capture the diversity of livelihood portfolios in East Africa. Using population representative data from 35,799 households in Kenya, Ethiopia, and Tanzania, we estimate household wealth along two different dimensions, associated respectively with success in wage economies and agricultural economies. Regression models for men and women show consistent and opposing associations between type of wealth and HIV infection. Controlling for age, education, and urban dwelling, increasing achievement along the wage economy dimension is positively (often significantly) associated with HIV infection. In contrast, increasing achievement along the agricultural economy dimension is often negatively associated with HIV infection, and is never associated with increased HIV risk. Interestingly, variables to assess risky sexual behaviors do not mediate the relationship between either type of wealth and HIV infection. Our results suggest that future studies on the relationship between HIV and wealth need to take into account the different dimensions of household wealth found in East African countries. Our results also generate new, important questions about why and how different forms of wealth drive HIV infection.

    KW - Africa

    KW - HIV

    KW - Livelihoods

    KW - Social determinants of health

    KW - Wealth

    UR - http://www.scopus.com/inward/record.url?scp=85054041350&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=85054041350&partnerID=8YFLogxK

    U2 - 10.1016/j.worlddev.2018.09.015

    DO - 10.1016/j.worlddev.2018.09.015

    M3 - Article

    VL - 113

    SP - 344

    EP - 351

    JO - World Development

    JF - World Development

    SN - 1873-5991

    ER -