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

Cust, H., Lepine, A., Treibich, C. , Powell-Jackson, T., Radice, R. ORCID: 0000-0002-6316-3961 & Ndour, C. T. (2024). Trading HIV for Sheep: Risky sexual behaviour and the response of female sex workers to Tabaski in Senegal. Health Economics, 33(1), pp. 153-193. doi: 10.1002/hec.4756


We use a cohort of female sex workers in Senegal to show how large anticipated economic shocks lead to increased risky sexual behaviour. 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 animal for sacrifice. Condom use, measured robustly via the list experiment, falls by between 27.3pp (65.5%) and 43.1pp (22.7%) in the 9 days before Tabaski, or a maximum of 49.5pp (76%) in the week block preceding Tabaski. The evidence suggests the economic pressures from Tabaski are key to driving the behaviour change observed in the context that condomless sex commands a price premium. 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 behaviours for female sex workers, a key population at high risk of HIV infection, for at least one 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 behavioural response to shocks of this type, policy should be carefully designed to protect vulnerable women against anticipated shocks.

Publication Type: Article
Additional Information: © 2023 The Authors. Health Economics published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Publisher Keywords: Economic shocks, Risky sexual behaviour, HIV, Female sex workers, Condomless sex, Tabaski
Subjects: D History General and Old World > DT Africa
H Social Sciences > HC Economic History and Conditions
H Social Sciences > HD Industries. Land use. Labor
H Social Sciences > HN Social history and conditions. Social problems. Social reform
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments: Bayes Business School > Actuarial Science & Insurance
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