Answer: It has spread over time.
Step-by-step explanation:
Since 1958, life expectancy had been constantly rising in the four countries under study (Botswana, South Africa, Keny, and Zimbabwe).
Suddenly, in 1988, around the time HIV/AIDS started to spread in Africa, life expectancy began to lessen abruptly. By 2003, life expectancy is lower than the one registered in 1958, in all the countries under study.