Economic Shocks and Risky Sexual Behaviours: A Systematic Review of the Literature

Abstract

This systematic review investigates the role of economic shocks in explaining HIV transmission through risky sexual behaviors. With natural disasters and global economic shocks becoming more prevalent and HIV disproportionately affecting young women in low- and middle-income countries, understanding the contribution of such shocks in driving risky sexual behaviors of both men and women is key in the response to HIV. The systematic review brings together a diverse literature, identifying for inclusion 35 papers containing 31 unique negative and 11 unique positive economic shocks combined with 322 risky sex and health outcomes. We find that increases in risky sexual behaviors are more sensitive to negative shocks than decreases are to positive shocks. Those already at risk of engaging in transactional or commercial sex are particularly vulnerable to temporary negative shocks increasing high risk behaviors. Persistent negative shocks consistently lead to increased risky sex in all samples. The implications for policy are that protecting against negative economic shocks will likely be effective in preventing STIs and HIV in low- and-middle income countries.