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Characteristics of individuals afflicted by AIDS-related mortality in Zambia

Antony Chapoto and T.S. Jayne

Food Security Research Project

Working paper No. 14

August 2005

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Campaigns to prevent the spread of HIV/AIDS require accurate knowledge of the characteristics of those most likely to contract the disease. Studies conducted in Sub-Saharan Africa during the 1980s and early 1990s generally found a positive correlation between socioeconomic characteristics such as education, income, and wealth and subsequent contraction of HIV. However, as the disease has progressed, the relationship between socioeconomic status and HIV contraction may have changed in many areas, although there is little hard evidence to support this.

Using nationally representative panel data on 18,821 individuals between 15-59 years of age in rural Zambia surveyed in 2001 and 2004, we estimate probit models to determine the ex ante socioeconomic characteristics of individuals and households who are subsequently afflicted by prime-age adult mortality. The results of these models are used to report the probabilities of disease-related mortality over a three-year period for a range of individual profiles that differ by gender, level of income, education, months residing away from home, distance to district town, and other individual and household characteristics.

The study highlights 10 major findings: (1) within the three-year period between May 2001 and May 2004, the probabilities of disease-related death for a prime-aged male and female were roughly 0.6% and 1.1%, respectively; (2) 61% of the prime-age deaths observed in this nationally-representative rural sample were women, supporting other findings that women are being disproportionately afflicted by the disease; (3) single women and men are 2 to 5 times more likely to die of disease-related causes as women and men who are the heads or spouses of their households; (4) females are more likely to die at an earlier age than their male counterparts; (5) relatively wealthy men (defined according to household assets and income) are 1.4 to 1.8 times more likely to die than relatively poor men; (6) relatively wealthy and poor women are equally likely to die of disease-related causes; (7) among relatively poor women, those having some form of formal or informal business income are 15% less likely to die of disease-related causes than those without any form of business income; (8), by contrast, among relatively non-poor women, those with business income were 7% more likely to die than those without business income; (9) educational attainment was largely unrelated to vulnerability to death for men and only weakly so for women; and (10) irrespective of income status, prime-aged men and women experiencing a prior death in their household are 23.0 and 18.1 times more likely to die of disease-related causes than men and women in households with no prime-age deaths in the past 8 years. The predicted probability of death was 12.4% and 16.3% for men and women experiencing a prior-disease-related death in their household in the past 8 years versus 0.54% and 0.90% for men and women not experiencing a prior prime-aged death. Of the 362 households experiencing prime-age mortality between 2001 and 2004, 15% of them suffered multiple prime-age deaths. In this way, AIDS differs from other kinds of diseases (e.g., malaria), which does not appreciably raise the likelihood of subsequent death in the family after one member contracts the disease. These results hold many important implications for poverty reduction strategies in areas hard-hit by AIDS, such as most of eastern and southern Africa.

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