Economic inequality and HIV in South Africa

Abstract

The aim of this thesis is to study the association between economic inequality and HIV in South Africa, since relatively recent research has suggested that economic inequality may be a structural driver in the HIV epidemic, especially in sub-Saharan Africa. Economic inequality is measured at the provincial and municipal level using an asset index to approximate household wealth. The asset index is constructed through multiple correspondence analysis using variables on household assets and amenities. Economic inequality is calculated using the Gini coefficient. The effects of inequality are estimated with a multilevel mixed-effects logistic regression model. When both men and women are included in the sample, municipal inequality proves to be insignificant while an increase in household wealth increases the odds of being HIV positive. Disaggregating the analysis by sex yields different results: for males, the effect is negligible. For females, higher levels of municipal inequality increases the odds of being HIV positive, and women living in the most unequal municipality is 4.383 times as likely to be HIV positive than women in the least unequal municipality are. Economic household wealth is also a significant predictor for HIV serostatus, where a higher level of wealth is associated with higher odds of being HIV positive. The data used in this thesis is from 2005 and is supplied by the Human Sciences Research Council.