IDEAS home Printed from https://ideas.repec.org/p/feb/natura/00550.html
   My bibliography  Save this paper

Love in the Time of HIV: Testing as a Signal of Risk

Author

Listed:
  • Laura Derksen
  • Adamson Muula
  • Joep van Oosterhout

Abstract

The HIV epidemic in southern Africa has important consequences for economic development. The epidemic could be stopped by a universal test and treat policy, as antiretroviral drugs block the spread of the virus. However, demand for HIV testing and treatment are surprisingly low. This paper develops a model in which the decision to seek an HIV test is a signal of infection, and those who seek a test are subject to statistical discrimination from potential sexual partners. We evaluate an information experiment designed to test the theory, and find evidence that this form of discrimination is a significant barrier to HIV testing. In particular, we provide information at the community level on the public benefit of antiretroviral therapy: because the drugs prevent HIV transmission, a person who is tested and treated for HIV is a relatively safe sexual partner. This information reduces discrimination and increases HIV testing, with the strongest effects in communities where the new information becomes common knowledge. The results demonstrate that discrimination towards HIV positive individuals can be due to rational behavior by a misinformed public, and that providing new information can be an effective way to mitigate its effects.

Suggested Citation

  • Laura Derksen & Adamson Muula & Joep van Oosterhout, 2016. "Love in the Time of HIV: Testing as a Signal of Risk," Natural Field Experiments 00550, The Field Experiments Website.
    • Handle: RePEc:feb:natura:00550
    as

    Download full text from publisher

    File URL: http://s3.amazonaws.com/fieldexperiments-papers2/papers/00550.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Joseph G. Altonji & Charles R. Pierret, 2001. "Employer Learning and Statistical Discrimination," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 116(1), pages 313-350.
    2. Oster, Emily, 2012. "HIV and sexual behavior change: Why not Africa?," Journal of Health Economics, Elsevier, vol. 31(1), pages 35-49.
    3. Moffitt, Robert, 1983. "An Economic Model of Welfare Stigma," American Economic Review, American Economic Association, vol. 73(5), pages 1023-1035, December.
    4. Sarah Baird & Ephraim Chirwa & Craig McIntosh & Berk Özler, 2010. "The short‐term impacts of a schooling conditional cash transfer program on the sexual behavior of young women," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 55-68, September.
    5. Roland Benabou & Jean Tirole, 2011. "Laws and Norms," NBER Working Papers 17579, National Bureau of Economic Research, Inc.
    6. Vivian Hoffmann & Jacob R. Fooks & Kent D. Messer, 2014. "Measuring and Mitigating HIV Stigma: A Framed Field Experiment," Economic Development and Cultural Change, University of Chicago Press, vol. 62(4), pages 701-726.
    7. Pascaline Dupas, 2011. "Do Teenagers Respond to HIV Risk Information? Evidence from a Field Experiment in Kenya," American Economic Journal: Applied Economics, American Economic Association, vol. 3(1), pages 1-34, January.
    8. Jalan, Jyotsna & Somanathan, E., 2008. "The importance of being informed: Experimental evidence on demand for environmental quality," Journal of Development Economics, Elsevier, vol. 87(1), pages 14-28, August.
    9. Friedman, Willa Helterline, 2018. "Antiretroviral drug access and behavior change," Journal of Development Economics, Elsevier, vol. 135(C), pages 392-411.
    10. Besley, Timothy & Coate, Stephen, 1992. "Understanding welfare stigma: Taxpayer resentment and statistical discrimination," Journal of Public Economics, Elsevier, vol. 48(2), pages 165-183, July.
    11. McKenzie, David, 2012. "Beyond baseline and follow-up: The case for more T in experiments," Journal of Development Economics, Elsevier, vol. 99(2), pages 210-221.
    12. Coate, Stephen & Loury, Glenn C, 1993. "Will Affirmative-Action Policies Eliminate Negative Stereotypes?," American Economic Review, American Economic Association, vol. 83(5), pages 1220-1240, December.
    13. Baird, Sarah & Gong, Erick & McIntosh, Craig & Özler, Berk, 2014. "The heterogeneous effects of HIV testing," Journal of Health Economics, Elsevier, vol. 37(C), pages 98-112.
    14. Rebecca L. Thornton, 2008. "The Demand for, and Impact of, Learning HIV Status," American Economic Review, American Economic Association, vol. 98(5), pages 1829-1863, December.
    15. Oriana Bandiera & Niklas Buehren & Robin Burgess & Markus Goldstein & Selim Gulesci & Imran Rasul & Munshi Sulaiman, 2013. "Empowering Adolescent Girls in Uganda," World Bank Publications - Reports 25458, The World Bank Group.
    16. Jobiba Chinkhumba & Susan Godlonton & Rebecca Thornton, 2014. "The Demand for Medical Male Circumcision," American Economic Journal: Applied Economics, American Economic Association, vol. 6(2), pages 152-177, April.
    17. Emily Oster & Ira Shoulson & E. Ray Dorsey, 2013. "Optimal Expectations and Limited Medical Testing: Evidence from Huntington Disease," American Economic Review, American Economic Association, vol. 103(2), pages 804-830, April.
    18. Madajewicz, Malgosia & Pfaff, Alexander & van Geen, Alexander & Graziano, Joseph & Hussein, Iftikhar & Momotaj, Hasina & Sylvi, Roksana & Ahsan, Habibul, 2007. "Can information alone change behavior? Response to arsenic contamination of groundwater in Bangladesh," Journal of Development Economics, Elsevier, vol. 84(2), pages 731-754, November.
    19. Marcin P?ski & Bal?zs Szentes, 2013. "Spontaneous Discrimination," American Economic Review, American Economic Association, vol. 103(6), pages 2412-2436, October.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Cortés, Darwin & Gamboa, Luis Fernando & Rodríguez-Lesmes, Paul, 2020. "Contraception, Intra-household Behaviour and Epidemic: Evidence from the Zika crisis in Colombia," Working papers 66, Red Investigadores de Economía.
    2. Derksen, Laura & Leclerc, Catherine Michaud & Souza, Pedro CL, 2019. "Searching for Answers: The Impact of Student Access to Wikipedia," CAGE Online Working Paper Series 450, Competitive Advantage in the Global Economy (CAGE).
    3. Derksen, Laura & Leclerc, Catherine Michaud & Souza, Pedro CL, 2019. "Searching for Answers : The Impact of Student Access to Wikipedia," The Warwick Economics Research Paper Series (TWERPS) 1236, University of Warwick, Department of Economics.
    4. Ahmed, Shahira & Autrey, Jessica & Katz, Ingrid T. & Fox, Matthew P. & Rosen, Sydney & Onoya, Dorina & Bärnighausen, Till & Mayer, Kenneth H. & Bor, Jacob, 2018. "Why do people living with HIV not initiate treatment? A systematic review of qualitative evidence from low- and middle-income countries," Social Science & Medicine, Elsevier, vol. 213(C), pages 72-84.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Derksen, Laura & Muula, Adamson & van Oosterhout, Joep, 2022. "Love in the time of HIV: How beliefs about externalities impact health behavior," Journal of Development Economics, Elsevier, vol. 159(C).
    2. David Mmopelwa & Oliver Morrissey & Trudy Owens, 2021. "HIV/AIDS and sexual behaviour in Botswana," Discussion Papers 2021-03, University of Nottingham, CREDIT.
    3. Lei, Xiaoyan & Song, Guangxiang & Su, Xuejuan, 2021. "Information, Belief, and Health Behavior: Evidence from China," Working Papers 2021-9, University of Alberta, Department of Economics.
    4. Bharadwaj, Prashant & Pai, Mallesh M. & Suziedelyte, Agne, 2017. "Mental health stigma," Economics Letters, Elsevier, vol. 159(C), pages 57-60.
    5. Cohen, Jessica & Saran, Indrani, 2018. "The impact of packaging and messaging on adherence to malaria treatment: Evidence from a randomized controlled trial in Uganda," Journal of Development Economics, Elsevier, vol. 134(C), pages 68-95.
    6. Dillon, Andrew & Friedman, Jed & Serneels, Pieter, 2014. "Health Information, Treatment, and Worker Productivity: Experimental Evidence from Malaria Testing and Treatment among Nigerian Sugarcane Cutters," IZA Discussion Papers 8074, Institute of Labor Economics (IZA).
    7. Marshall Burke & Erick Gong & Kelly Jones, 2015. "Income Shocks and HIV in Africa," Economic Journal, Royal Economic Society, vol. 125(585), pages 1157-1189, June.
    8. Mesnard, Alice & Vera-Hernández, Marcos & Fitzsimons, Emla & Malde, Bansi, 2012. "Household Responses to Information on Child Nutrition: Experimental Evidence from Malawi," CEPR Discussion Papers 8915, C.E.P.R. Discussion Papers.
    9. Fitzpatrick, Anne & Beg, Sabrin & Derksen, Laura & Karing, Anne & Kerwin, Jason & Lucas, Adrienne M. & Ordaz Reynoso, Natalia & Squires, Munir, 2021. "Health knowledge and non-pharmaceutical interventions during the Covid-19 pandemic in Africa," Journal of Economic Behavior & Organization, Elsevier, vol. 190(C), pages 33-53.
    10. Krämer, Marion & Kumar, Santosh & Vollmer, Sebastian, 2021. "Anemia, diet, and cognitive development: Impact of health information on diet quality and child nutrition in rural India," Journal of Economic Behavior & Organization, Elsevier, vol. 190(C), pages 495-523.
    11. Anselm Rink & Ramona Wong-Grünwald, 2017. "How effective are HIV behaviour change interventions? Experimental evidence from Zimbabwe," Journal of Development Effectiveness, Taylor & Francis Journals, vol. 9(3), pages 361-388, July.
    12. Bennear, Lori & Tarozzi, Alessandro & Pfaff, Alexander & Balasubramanya, Soumya & Matin Ahmed, Kazi & van Geen, Alexander, 2013. "Impact of a randomized controlled trial in arsenic risk communication on household water-source choices in Bangladesh," Journal of Environmental Economics and Management, Elsevier, vol. 65(2), pages 225-240.
    13. Fitzsimons, Emla & Malde, Bansi & Mesnard, Alice & Vera-Hernández, Marcos, 2016. "Nutrition, information and household behavior: Experimental evidence from Malawi," Journal of Development Economics, Elsevier, vol. 122(C), pages 113-126.
    14. Hans-Peter Kohler & Rebecca L. Thornton, 2012. "Conditional Cash Transfers and HIV/AIDS Prevention: Unconditionally Promising?," The World Bank Economic Review, World Bank, vol. 26(2), pages 165-190.
    15. Pascaline Dupas & Edward Miguel, 2016. "Impacts and Determinants of Health Levels in Low-Income Countries," NBER Working Papers 22235, National Bureau of Economic Research, Inc.
    16. Yang, Dean & Allen, James & Mahumane, Arlete & Riddell, James & Yu, Hang, 2023. "Knowledge, stigma, and HIV testing: An analysis of a widespread HIV/AIDS program," Journal of Development Economics, Elsevier, vol. 160(C).
    17. Singh, Prakarsh & Mitra, Sandip, 2017. "Incentives, information and malnutrition: Evidence from an experiment in India," European Economic Review, Elsevier, vol. 93(C), pages 24-46.
    18. Stephen Smith, 2018. "Development Economics Meets the Challenges of Lagging U.S. Areas: Applications to Education, Health and Nutrition, Behavior, and Infrastructure," Working Papers 2018-7, The George Washington University, Institute for International Economic Policy.
    19. Rink, Anselm & Wong-Grünwald, Ramona, 2017. "How effective are HIV behaviour change interventions? Experimental evidence from Zimbabwe," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 9(3), pages 361-388.
    20. Herrera-Almanza, Catalina & Rosales-Rueda, Maria F., 2020. "Reducing the Cost of Remoteness: Community-Based Health Interventions and Fertility Choices," Journal of Health Economics, Elsevier, vol. 73(C).

    More about this item

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:feb:natura:00550. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Francesca Pagnotta (email available below). General contact details of provider: http://www.fieldexperiments.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.