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Antiretroviral Therapy and Demand for HIV Testing: Evidence from Zambia

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Abstract

This paper examines the effects of antiretroviral therapy (ART) on demand for HIV testing and of ART-induced testing on demand for risky sexual behavior. I provide a model of sexual behavior decision-making under uncertainty and estimate the structural parameters of the model using nationally representative survey data from Zambia on HIV testing decisions before and after the introduction of ART. The empirical results indicate that although the introduction of ART increased demand for HIV testing, the ART allocation process limited the prevention benefit of ART-induced testing. Simulation results show that eliminating this prevention inefficiency while holding the supply of ART constant would increase the prevention impact of ART-induced testing more than four-fold. More generally, the analysis indicates that existing studies which examine "universal" testing or quasi-experimental testing programs understate the efficacy of standard voluntary counseling and testing programs.

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Bibliographic Info

Paper provided by Department of Economics, Williams College in its series Center for Development Economics with number 2011-01.

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Length: 48 pages
Date of creation: Oct 2010
Date of revision:
Handle: RePEc:wil:wilcde:2011-01

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Keywords: HIV/AIDS; Beliefs; Selection; Rationing; Zambia;

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References

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  1. Paul Gertler & Manisha Shah & Stefano M. Bertozzi, 2005. "Risky Business: The Market for Unprotected Commercial Sex," Journal of Political Economy, University of Chicago Press, vol. 113(3), pages 518-550, June.
  2. Robinson, Jonathan & Yeh, Ethan, 2009. "Transactional sex as a response to risk in western Kenya," Policy Research Working Paper Series 4857, The World Bank.
  3. Sebnem Kalemli-Ozcan & Belgi Turan & Chinhui Juhn, 2009. "HIV and Fertility in Africa: First Evidence from Population Based Surveys," 2009 Meeting Papers 650, Society for Economic Dynamics.
  4. Emily Oster, 2007. "Routes of Infection: Exports and HIV Incidence in Sub-Saharan Africa," NBER Working Papers 13610, National Bureau of Economic Research, Inc.
  5. Lena Edlund & Evelyn Korn, 2002. "A Theory of Prostitution," Journal of Political Economy, University of Chicago Press, vol. 110(1), pages 181-214, February.
  6. Emily Oster, 2007. "HIV and Sexual Behavior Change: Why Not Africa?," NBER Working Papers 13049, National Bureau of Economic Research, Inc.
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Blog mentions

As found by EconAcademics.org, the blog aggregator for Economics research:
  1. Economic Growth and the HIV/AIDS Pandemic
    by Ariel Goldring in Free Market Mojo on 2010-11-21 15:00:01
  2. Economic booms and risky sexual behavior (Ref. Zambia)
    by UDADISI in UDADISI on 2012-10-11 21:58:00
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Cited by:
  1. Andreas Kotsadam & Anja Tolonen, 2013. "Mineral Mining and Female Employment," OxCarre Working Papers 114, Oxford Centre for the Analysis of Resource Rich Economies, University of Oxford.
  2. Aureo de Paula & Gil Shapira & Petra E. Todd, 2009. "How Beliefs about HIV Status Affect Risky Behaviors: Evidence from Malawi, Second Version," PIER Working Paper Archive 10-004, Penn Institute for Economic Research, Department of Economics, University of Pennsylvania, revised 27 Jan 2010.
  3. Okeke, Edward N. & Adepiti, Clement A. & Ajenifuja, Kayode O., 2013. "What is the price of prevention? New evidence from a field experiment," Journal of Health Economics, Elsevier, vol. 32(1), pages 207-218.
  4. Aureo de Paula & Gil Shapira & Petra E. Todd, 2008. "How Beliefs about HIV Status Affect Risky Behaviors: Evidence from Malawi1, Second Version," PIER Working Paper Archive 09-031, Penn Institute for Economic Research, Department of Economics, University of Pennsylvania, revised 01 Aug 2009.

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