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

Henry Cust, Aurélia Lépine, Carole Treibich (), Timothy Powell‐jackson, Rosalba Radice and Cheikh Tidiane Ndour
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Henry Cust: LSHTM - London School of Hygiene and Tropical Medicine
Aurélia Lépine: UCL - University College of London [London]
Carole Treibich: GAEL - Laboratoire d'Economie Appliquée de Grenoble - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement - UGA - Université Grenoble Alpes - Grenoble INP - Institut polytechnique de Grenoble - Grenoble Institute of Technology - UGA - Université Grenoble Alpes
Timothy Powell‐jackson: LSHTM - London School of Hygiene and Tropical Medicine
Rosalba Radice: City University of London
Cheikh Tidiane Ndour: Institut d'hygiène Sociale, Dakar,

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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.

Keywords: Condomless sex; Economic shocks; Female sex workers; HIV; Risky sexual behavior; Tabaski (search for similar items in EconPapers)
Date: 2024-01
Note: View the original document on HAL open archive server: https://hal.science/hal-04271238v1
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Published in Health Economics, 2024, 33 (1), pp.153-193. ⟨10.1002/hec.4756⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-04271238

DOI: 10.1002/hec.4756

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