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Is sex like driving? HIV prevention and risk compensation

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  • Wilson, Nicholas L.
  • Xiong, Wentao
  • Mattson, Christine L.

Abstract

Risk compensation has been called the “Achilles' heel” of HIV prevention policies (Cassell et al., 2006). This paper examines the behavioral response to male circumcision, a major HIV prevention policy currently being implemented throughout much of Sub-Saharan Africa. Contrary to the presumption of risk compensation, we find that the response due to the perceived reduction in HIV transmission appears to have been a reduction in risky sexual behavior. We suggest a mechanism for this finding: circumcision may reduce fatalism about acquiring HIV/AIDS and increase the salience of the tradeoff between engaging in additional risky behavior and avoiding acquiring HIV. We also find what appears to be a competing effect that does not operate through the circumcision recipient's belief about the reduction in the risk of acquiring HIV.

Suggested Citation

  • Wilson, Nicholas L. & Xiong, Wentao & Mattson, Christine L., 2014. "Is sex like driving? HIV prevention and risk compensation," Journal of Development Economics, Elsevier, vol. 106(C), pages 78-91.
    • Handle: RePEc:eee:deveco:v:106:y:2014:i:c:p:78-91
    DOI: 10.1016/j.jdeveco.2013.08.012
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    Cited by:

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    2. Teresa Molina Millán & Karen Macours, 2017. "Attrition in randomized control trials: Using tracking information to correct bias," FEUNL Working Paper Series novaf:wp1702, Universidade Nova de Lisboa, Faculdade de Economia.
    3. Manuela Angelucci & Daniel Bennett, 2021. "Adverse Selection in the Marriage Market: HIV Testing and Marriage in Rural Malawi [Marrying Up: The Role of Sex Ratio in Assortative Matching]," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 88(5), pages 2119-2148.
    4. Seres, Gyula & Balleyer, Anna & Cerutti, Nicola & Friedrichsen, Jana & Süer, Müge, 2021. "Face mask use and physical distancing before and after mandatory masking: No evidence on risk compensation in public waiting lines," Journal of Economic Behavior & Organization, Elsevier, vol. 192(C), pages 765-781.
    5. Seres, Gyula & Balleyer, Anna Helen & Cerutti, Nicola & Danilov, Anastasia & Friedrichsen, Jana & Liu, Yiming & Süer, Müge, 2021. "Face masks increase compliance with physical distancing recommendations during the COVID-19 pandemic," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 7(2), pages 139-158.
    6. Seres, Gyula & Balleyer, Anna & Cerutti, Nicola & Friedrichsen, Jana & Süer, Müge, 2020. "Face mask use and physical distancing before and after mandatory masking: Evidence from public waiting lines," Discussion Papers, Research Unit: Economics of Change SP II 2020-305, WZB Berlin Social Science Center.
    7. Li Han & Xinzheng Shi & Ming-ang Zhang, 2022. "How Does Matching Uncertainty Affect Marital Surplus? Theory and Evidence from China," HKUST CEP Working Papers Series 202202, HKUST Center for Economic Policy.
    8. Wilson, Nicholas, 2021. "Why is ageing associated with lower adoption of new technologies? Evidence from voluntary medical male circumcision and a structural model," The Journal of the Economics of Ageing, Elsevier, vol. 19(C).
    9. Baranov, Victoria & Bennett, Daniel & Kohler, Hans-Peter, 2015. "The indirect impact of antiretroviral therapy: Mortality risk, mental health, and HIV-negative labor supply," Journal of Health Economics, Elsevier, vol. 44(C), pages 195-211.
    10. repec:hal:wpaper:halshs-01222571 is not listed on IDEAS
    11. Fichera, Eleonora & Banks, James & Siciliani, Luigi & Sutton, Matt, 2018. "Does patient health behaviour respond to doctor effort?," Journal of Economic Behavior & Organization, Elsevier, vol. 156(C), pages 225-251.
    12. Teresa Molina Millan & Karen Macours, 2017. "Attrition in randomized control trials: Using tracking information to correct bias," NOVAFRICA Working Paper Series wp1702, Universidade Nova de Lisboa, Nova School of Business and Economics, NOVAFRICA.
    13. Friedman, Willa Helterline, 2018. "Antiretroviral drug access and behavior change," Journal of Development Economics, Elsevier, vol. 135(C), pages 392-411.
    14. Wilson, Nicholas & Janicki, Martha, 2016. "A cut above the rest? Private anthropometrics in marriage markets," Economics & Human Biology, Elsevier, vol. 23(C), pages 164-179.
    15. Friedman, Willa & Wilson, Nicholas, 2022. "Can nudging overcome procrastinating on preventive health investments?," Economics & Human Biology, Elsevier, vol. 45(C).
    16. Chong, Alberto & Restrepo, Pascual, 2017. "Regulatory protective measures and risky behavior: Evidence from ice hockey," Journal of Public Economics, Elsevier, vol. 151(C), pages 1-11.
    17. Jisoo Hwang & Seung‐sik Hwang & Hyuncheol Bryant Kim & Jungmin Lee & Junseok Lee, 2024. "Risk compensation after COVID‐19 vaccination: Evidence from vaccine rollout by exact birth date in South Korea," Health Economics, John Wiley & Sons, Ltd., vol. 33(8), pages 1811-1830, August.
    18. Matthew Quaife & Fern Terris‐Prestholt & Zindoga Mukandavire & Peter Vickerman, 2021. "Modelling the effect of market forces on the impact of introducing human immunodeficiency virus pre‐exposure prophylaxis among female sex workers," Health Economics, John Wiley & Sons, Ltd., vol. 30(3), pages 659-679, March.

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    More about this item

    Keywords

    Beliefs; HIV/AIDS; Kenya; Male circumcision; Risk compensation;
    All these keywords.

    JEL classification:

    • D81 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Criteria for Decision-Making under Risk and Uncertainty
    • D84 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Expectations; Speculations
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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