This paper investigates the long-term impact of historical missionary activity on HIV in sub-Saharan Africa. On the one hand, missionaries were the first to invest in modern medicine in the region. On the other hand, Christianity influenced sexual beliefs and behaviors that affect the risk of contagion. We build a new geocoded dataset locating Protestant and Catholic missions in the early 20th century, as well as the health facilities they invested in, that we combine with individual-level Demographic and Health Survey data. With these data, we can address separately these two channels, within regions close to historical missionary settlements. First, we show that proximity to historical missionary health facilities decreases the likelihood of HIV; persistence in healthcare provision and safer sexual behaviors in the region explain this result. Second, we show that regions close to historical missionary settlements exhibit higher likelihood of HIV. This effect is driven by the Christian population in our sample. This suggests conversion to Christianity as a possible explanatory channel. Our findings are robust to alternative specifications addressing selection.

中文翻译：

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性与使命：早期基督教宣教对撒哈拉以南非洲艾滋病毒的冲突影响

本文调查了历史传教活动对撒哈拉以南非洲艾滋病毒的长期影响。一方面，传教士是第一批在该地区投资现代医学的人。另一方面，基督教影响了影响传染风险的性信仰和行为。我们构建了一个新的地理编码数据集，定位 20 世纪初的新教和天主教传教士，以及他们投资的卫生设施，我们将其与个人层面的人口和健康调查数据相结合。有了这些数据，我们可以在靠近历史传教士定居点的地区分别处理这两个渠道。首先，我们表明靠近历史传教士卫生设施会降低感染艾滋病毒的可能性；该地区持续提供医疗保健和更安全的性行为解释了这一结果。其次，我们表明靠近历史传教士定居点的地区表现出更高的艾滋病毒感染可能性。这种影响是由我们样本中的基督徒人口驱动的。这表明皈依基督教是一个可能的解释渠道。我们的发现对于解决选择的替代规范是稳健的。