Unequal Returns: The Impact of Antiretroviral Treatment on AIDS Mortality in Addis Ababa, Ethiopia

Mathew Creighton, University of Pennsylvania
Georges Reniers, University of Colorado at Boulder and University of the Witwatersrand
Brodie Ferguson, Stanford University

In most countries with generalized HIV/AIDS epidemics few monitoring systems are in place to trace the impact of antiretroviral treatment (ART) programs. Its effectiveness and the degree of equity or inequity in the access to treatment, therefore, remain largely unknown. In this paper we test these hypotheses using data from a surveillance of burials at all cemeteries of Addis Ababa from 2001 to 2005; the period during which ART was introduced in Ethiopia. These data are complemented with census data and results from verbal autopsy interviews. We carry out aggregate-level spatial regressions to test whether educational and socio-economic status is correlated with a beneficial change in AIDS mortality following the introduction of ART. We find that this is indeed the case and that supports the hypothesis that ART has intensified health inequity.