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Sex and the Mission: The conflicting effects of early Christian investments on sub-Saharan Africa's HIV epidemic

Joint with Julia Cagé

Abstract: This article investigates the long-term impact of historical missionary activity on HIV in sub-Saharan Africa. On the one hand, missionaries were the first to invest in modern medicine in the region. On the other hand, Christianity influenced sexual beliefs and behaviors that affect the risk of contagion. We build a new geocoded dataset locating Protestant and Catholic missions in the early 20th century, as well as the health facilities they invested in. With these data, we can address separately these two channels, within regions close to historical missionary settlements.  First, we show that  proximity to historical missionary  health facilities  decreases the likelihood of  HIV; persistence in healthcare provision and safer sexual behaviors in the region explain this result.   Second, we show that regions close to historical missionary settlements  exhibit higher likelihood of HIV. This effect is  driven by the Christian population in our sample. This suggests conversion to  Christianity  as a possible explanatory channel.  Our findings are robust to alternative specifications  addressing selection.


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