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Demographic Impact of HIV on Africa's Elderly


  • Assistant Professor, Medicine (CHP/PCOR)
  • Professor, Medicine

The overall goal of this project was to estimate the relationship between the HIV epidemic in Africa and mortality patterns of Africa's elderly.  The lead investigator audited Professor Shripad Tuljapurkar's demography class to have a more nuanced understanding of the methods involved in mortality estimations.  He identified the data sources to be used in this project, and employed the services of a programmer at Stanford's Quantitative Sciences Unit, Jessica Kubo, to help with the data analysis.  They revised the proposed approach after they discovered a new source of data that provides both a census of household populations and recent household deaths in nationally representative surveys in 10 African countries between 2005 and 2009.  They used this data to estimate age- and gender-specific mortality directly and compare those estimates to the official estimates published by the UN Population Division (UNPD) and the World Health Organization (WHO).  To the best of their knowledge, they were the first ones to use this information for demographic purposes.  The researchers found very close concordance between their direct estimates of mortality up to age 60.  From age 60 upwards, however, they found a consistent and widening (with age) gap in the estimates that suggest old-age mortality in these countries is over-estimated by the UNPD and WHO.  They tested the determinants of these discrepancies, but think the HIV epidemic's burden on prime-age adults is skewing modeled estimates of older-age mortality, and that in fact older Africans are in better health than what demographic estimates suggest.  They presented the work in a local (Stanford) demography conference, and Dr. Bendavid travelled to Washington DC to discuss the work with colleagues at the Population Association of America conference. A manuscript entitled, “Comparative analysis of old-age mortality estimations in Africa” was published in PLoS One in 2011, and another manuscript “United States aid policy and induced abortion in sub-Saharan Africa” was published in Bull World Health Organization”.