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HIV Breakthroughs and Risk Sexual Behavior

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  • Dana Goldman
  • Darius Lakdawalla
  • Neeraj Sood

Abstract

Recent breakthroughs in the treatment of HIV have coincided with an increase in infection rates and an eventual slowing of reductions in HIV mortality. These trends may be causally related, if treatment improves the health and functional status of HIV+ individuals and allows them to engage in more sexual risk-taking. We examine this hypothesis empirically using access to health insurance as an instrument for treatment status. We find that treatment results in more sexual risk-taking by HIV+ adults, and possibly more of other risky behaviors like drug abuse. This relationship implies that breakthroughs in treating an incurable disease like HIV can increase precautionary behavior by the uninfected and thus reduce welfare. We also show that, in the presence of this effect, treatment and prevention are social complements for incurable diseases, even though they are substitutes for curable ones. Finally, there is less under-provision of treatment for an incurable disease than a curable one, because of the negative externalities associated with treating an incurable disease.

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Bibliographic Info

Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 10516.

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Date of creation: May 2004
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Publication status: published as Neeraj Sood & Dana Goldman, 2006. "HIV Breakthroughs and Risky Sexual Behavior," The Quarterly Journal of Economics, MIT Press, vol. 121(3), pages 1063-1102, 08.
Handle: RePEc:nbr:nberwo:10516

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  1. Charles R. Nelson & Richard Startz, 1988. "Some Further Results on the Exact Small Sample Properties of the Instrumental Variable Estimator," NBER Technical Working Papers 0068, National Bureau of Economic Research, Inc.
  2. Douglas Staiger & James H. Stock, 1997. "Instrumental Variables Regression with Weak Instruments," Econometrica, Econometric Society, vol. 65(3), pages 557-586, May.
  3. Philipson, Tomas, 2000. "Economic epidemiology and infectious diseases," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 33, pages 1761-1799 Elsevier.
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