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Income shocks and sexually transmitted infections in female sex workers

Principal Supervisor: Dr Aurelia Lepine (LSHTM)
Email: Aurelia.lepine@lshtm.ac.uk

Co-Supervisor: Dr Rosalba Radice (Birkbeck College)
Email: r.radice@bbk.ac.uk

Co-Supervisor: Dr Tim Powell-Jackson (LSHTM)
Email: Timothy.Powell-Jackson@lshtm.ac.uk

Project description

In West-Africa and India, where HIV prevalence is less than 1% in the general population, female sex workers (FSWs) remain the main core group involved in HIV transmission dynamics. In West-Africa, 75% of HIV infections among men are attributable to sexual intercourse with FSWs. In India, it has been estimated that an elimination of HIV risk associated with commercial sex would eliminate the heterosexual HIV epidemic. As a result in India and Senegal, resources to tackle the AIDS epidemic are prioritised towards FSWs. Despite the existence of these public health interventions, FSWs are still a main contributor to the AIDS epidemics: they are up to 7 and 9 times more likely to be infected with HIV in India and Senegal, respectively.

Previous research conducted in India and Senegal showed that although FSWs have a good knowledge of HIV risks and a good access to HIV prevention services, 15% and 20% of FSWs did not use a condom in their last commercial sex act, respectively. There is strong evidence that the main reason for engaging in unprotected sex is economic because the price charged for unprotected sex can be roughly doubled in both countries. In addition, there is some (but limited) evidence that FSWs exposed to an income shock use unprotected sex as a risk-coping mechanism to smooth consumption. However, there is no evidence of the effectiveness of risk-copying mechanisms (e.g. savings) to reduce risky sexual behaviours.

The aim of this project is to estimate the impact of income shocks on FSWs’ sexual behaviours in a rural Indian setting (Northern Karnataka and Southern Maharashtra states) and in an African urban setting (Dakar, Senegal) and to assess the effectiveness of self-insurance through precautionary savings as a risk-coping strategy.

The analysis will be based on two unique longitudinal datasets of FSWs. The first one, collected by the Karnataka Health Promotion Trust part of the Payana project, contains information on 1,500 FSWs located in rural Southern India surveyed 4 times over a 15-month period. The second one, collected by the lead PhD supervisor, contains information from 800 FSWs based in Dakar, Senegal, including 440 FSWs surveyed twice at a two-year interval.

Subject areas/ keywords

Development economics; Health Economics; Applied Microeconometrics; Microeconomics; Sex work; HIV/AIDS; Sexually transmitted infections; Global health; Risk-coping mechanisms

Candidate requirements

We invite applications from outstanding and highly motivated students who have a Masters degree in economics, health economics or a related discipline. An undergraduate degree (1stclass honours or 2.1) in economics or in a relevant discipline with demonstrable strong quantitative component (e.g. econometrics, statistics or mathematics) is desirable.

The studentship is open to applicants who would be assessed to have UK/EU fee status.

Key References

  • Robinson, J. and E. Yeh, Transactional sex as a response to risk in Western Kenya. American Economic Journal: Applied Economics, 2011. 3(1): p. 35-64.
  • Robinson, J. and E. Yeh, Risk-Coping through Sexual Networks Evidence from Client Transfers in Kenya. Journal of Human Resources, 2012. 47(1): p. 107-145.
  • Rao, V., Gupta, I., Lokshin, M., & Jana, S. (2003). Sex workers and the cost of safe sex: the compensating differential for condom use among Calcutta prostitutes. Journal of Development Economics, 71(2), 585-603.
  • Deaton, A., Saving and Liquidity Constraints. Econometrica, 1991. 59(5): p. 1221-1248.

Further information

Further information about PhDs at LSHTM is available here.

The successful student will be registered at: The London School of Hygiene & Tropical Medicine

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How to apply

Instructions for applicants

LSHTM uses an online application system

Please contact scholarships@lshtm.ac.uk for queries related to the submission of the application.

Please use the standard LSHTM application system to apply for this studentship and state clearly under the funding section that you are applying for this particular studentship. Since you are applying for an existing project you do not need to include a research proposal, so please instead upload a document which states that you are applying for this studentship.

The closing date for applications is: 1st March 2018