Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jan;33(1):153-193.
doi: 10.1002/hec.4756. Epub 2023 Nov 2.

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

Henry Cust  1 , Aurélia Lépine  2 , Carole Treibich  3 , Timothy Powell-Jackson  1 , Rosalba Radice  4 , Cheikh Tidiane Ndour  5
Affiliations

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

Henry Cust et al. Health Econ. 2024 Jan.

Abstract

We use a cohort of female sex workers (FSWs) in Senegal to show how large anticipated economic shocks lead to increased risky sexual behavior. 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 expensive animal for sacrifice. Condom use, measured robustly via the list experiment, falls by between 27.3 percentage points (pp) (65.5%) and 43.1 pp (22.7%) in the 9 days before Tabaski, or a maximum of 49.5 pp (76%) in the 7 day period preceding Tabaski. The evidence suggests the economic pressures from Tabaski are key to driving the behavior change observed through the price premium for condomless sex. 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 behaviors for FSWs, a key population at high risk of HIV infection, for at least 1 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 behavioral response to shocks of this type, policy should be carefully designed to protect vulnerable women against anticipated shocks.

Keywords: HIV; Tabaski; condomless sex; economic shocks; female sex workers; risky sexual behavior.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

FIGURE 1
FIGURE 1
Tabaski funding sources. Bar heights are the percentage of female sex workers (FSWs) that selected each category. ‘All sources of funding’ allowed respondents to tick as many sources as they had contributing to their costs. ‘Main source of funding’ allowed respondents to select only their main source of funding. Only those who are celebrating Tabaski.
FIGURE 2
FIGURE 2
Illustration of key survey dates.
FIGURE 3
FIGURE 3
Coefficient Graph of Parameter [β 3] of Models Estimated in Table 3. Includes controls.
FIGURE 4
FIGURE 4
Condom Prevalence with Varying Definitions of ‘close to’ Tabaski. Far from’ Tabaski values estimated as the prevalence of those defined as ‘far from’ Tabaski in specification 1 (Equation (6)) without controls, Table A4. ‘Close to’ Tabaski values estimated using the key parameters, beta 3 in specification 1 (Equation (6)) with controls as well as the 95% confidence intervals.
FIGURE 5
FIGURE 5
Distribution of last sex acts in relation to Tabaski, T D .
FIGURE A1
FIGURE A1
Example of T D Categorized to ‘close to’ and ‘far from’ Groups.
FIGURE A2
FIGURE A2
Coefficient Graph of Parameter [β 3] of Models Estimated in Table 3 without controls. Results tables for figures are available on request.
FIGURE A3
FIGURE A3
Distribution of Interview Date in relation to Tabaski, T act .
See this image and copyright information in PMC

References

    1. Aker, J. C. , Sawyer, M. , Goldstein, M. , O’Sullivan, M. , & McConnell, M. (2020). Just a bit of cushion: The role of a simple savings device in meeting planned and unplanned expenses in rural Niger. World Development, 128, 104772. 10.1016/j.worlddev.2019.104772 - DOI
    1. APAPS & IRESSEF . (2014). Etude pour l’estimation du nombre de travailleuses du sexe et des hommes qui ont des rapports sexuels avec des hommes dans la région de Dakar. Technical Report. Rapport commandité par la DLSI. le CNLS et FHI.
    1. Apolloni, A. , Nicolas, G. , Coste, C. , Mamy, A. B. E. , Yahya, B. , Arbi, A. S. E. , Gueya, M. B. , Baba, D. , Gilbert, M. , & Lancelot, R. (2018). Towards the description of livestock mobility in Sahelian Africa: Some results from a survey in Mauritania. PLOS ONE, 13(1), e0191565. publisher: Public Library of Science. 10.1371/JOURNAL.PONE.0191565 - DOI - PMC - PubMed
    1. Banerjee, A. V. , & Duflo, E. (2007). The economic lives of the poor. Journal of Economic Perspectives, 21(1), 141–167. 10.1257/jep.21.1.141 - DOI - PMC - PubMed
    1. Baral, S. , Muessig, K. , Wirtz, A. L. , Decker, M. R. , Sherman, S. G. , Baral, S. , Hopkins, J. , Beyrer, C. , Muessig, K. , Poteat, T. , Wirtz, A. L. , Decker, M. R. , Sherman, S. G. , & Kerrigan, D. (2012). Burden of HIV among female sex workers in low‐income and middle‐income countries: A systematic review and meta‐analysis. The Lancet Infectious Diseases, 12(7), 538–587. URL:. 10.1016/S1473 www.thelancet.com/infection - DOI - PubMed

Publication types