The sins of the church: The long-term impacts of Christian missionary praxis on HIV and sexual behaviour in Zambia

This study examines the long-term effect of Christian missionary exposure on HIV infection and related sexual behaviour in Zambia. I use distance to a historical missionary church and health facility as proxies for missionary exposure. I constructed a geocoded data set combining information on the historical locations of churches and missionary health centres with contemporary individual-level data. I find that individuals who live close to a historical missionary church have a higher likelihood of being infected with HIV. I find no significant effect of proximity to a missionary health centre on HIV. Considering that heterosexual transmission is the main channel of HIV transmission in Zambia, I analyse the effect of missionary exposure on sexual behaviour. The following patterns emerge: individuals who live close to a Protestant church are less likely to engage in premarital sexual abstinence; they also have their first sexual encounter at an earlier age, with the effect being stronger for men than women. Living near a Catholic church is associated with having a higher number of sexual partners.