IDEAS home Printed from https://ideas.repec.org/a/eee/deveco/v106y2014icp78-91.html
   My bibliography  Save this article

Is sex like driving? HIV prevention and risk compensation

Author

Listed:
  • 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
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0304387813001284
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.jdeveco.2013.08.012?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Keeler, Theodore E, 1994. "Highway Safety, Economic Behavior, and Driving Environment," American Economic Review, American Economic Association, vol. 84(3), pages 684-693, June.
    2. Oster, Emily, 2012. "HIV and sexual behavior change: Why not Africa?," Journal of Health Economics, Elsevier, vol. 31(1), pages 35-49.
    3. Daniel Bennett, 2012. "Does Clean Water Make You Dirty?: Water Supply and Sanitation in the Philippines," Journal of Human Resources, University of Wisconsin Press, vol. 47(1), pages 146-173.
    4. Darius Lakdawalla & Neeraj Sood & Dana Goldman, 2006. "HIV Breakthroughs and Risky Sexual Behavior," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 121(3), pages 1063-1102.
    5. Evans, William N & Graham, John D, 1991. "Risk Reduction or Risk Compensation? The Case of Mandatory Safety-Belt Use Laws," Journal of Risk and Uncertainty, Springer, vol. 4(1), pages 61-73, January.
    6. Dickie, Mark & Gerking, Shelby, 1997. "Genetic Risk Factors and Offsetting Behavior: The Case of Skin Cancer," Journal of Risk and Uncertainty, Springer, vol. 15(1), pages 81-97, October.
    7. Tomas J. Philipson & William H. Dow & Xavier Sala-i-Martin, 1999. "Longevity Complementarities under Competing Risks," American Economic Review, American Economic Association, vol. 89(5), pages 1358-1371, December.
    8. Clifford Winston & Vikram Maheshri & Fred Mannering, 2006. "An exploration of the offset hypothesis using disaggregate data: The case of airbags and antilock brakes," Journal of Risk and Uncertainty, Springer, vol. 32(2), pages 83-99, March.
    9. Michael Kremer, 1996. "Integrating Behavioral Choice into Epidemiological Models of AIDS," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 549-573.
    10. Peltzman, Sam, 1975. "The Effects of Automobile Safety Regulation," Journal of Political Economy, University of Chicago Press, vol. 83(4), pages 677-725, August.
    11. Michael Kremer, 1996. "Integrating Behavioral Choice into Epidemiological Models of the AIDS Epidemic," NBER Working Papers 5428, National Bureau of Economic Research, Inc.
    12. de Walque, Damien & Kazianga, Harounan & Over, Mead, 2010. "Antiretroviral therapy awareness and risky sexual behaviors : evidence from Mozambique," Policy Research Working Paper Series 5486, The World Bank.
    13. Alma Cohen & Liran Einav, 2003. "The Effects of Mandatory Seat Belt Laws on Driving Behavior and Traffic Fatalities," The Review of Economics and Statistics, MIT Press, vol. 85(4), pages 828-843, November.
    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. 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.
    2. Marlène Guillon & Josselin Thuilliez, 2015. "HIV and Rational risky behaviors: a systematic review of published empirical literature (1990-2013)," Post-Print halshs-01222571, HAL.
    3. 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.
    4. 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.
    5. 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.
    6. Friedman, Willa Helterline, 2018. "Antiretroviral drug access and behavior change," Journal of Development Economics, Elsevier, vol. 135(C), pages 392-411.
    7. 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.
    8. 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.
    9. 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.
    10. 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.
    11. 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.
    12. Friedman, Willa & Wilson, Nicholas, 2022. "Can nudging overcome procrastinating on preventive health investments?," Economics & Human Biology, Elsevier, vol. 45(C).
    13. 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).
    14. 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.
    15. repec:hal:wpaper:halshs-01222571 is not listed on IDEAS
    16. 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.
    17. 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.

    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. Friedman, Willa Helterline, 2018. "Antiretroviral drug access and behavior change," Journal of Development Economics, Elsevier, vol. 135(C), pages 392-411.
    2. repec:dau:papers:123456789/7310 is not listed on IDEAS
    3. Nicholas Wilson & Wentao Xiong & Christine Mattson, 2011. "Is Sex Like Driving? Risk Compensation Associated with Randomized Male Circumcision in Kisumu, Kenya," Center for Development Economics 2011-09, Department of Economics, Williams College, revised Jan 2012.
    4. Berlemann, Michael & Matthes, Andreas, 2014. "Positive externalities from active car safety systems," Journal of Policy Modeling, Elsevier, vol. 36(2), pages 313-329.
    5. Adeline Delavande & Dana Goldman & Neeraj Sood, 2010. "Criminal Prosecution and Human Immunodeficiency Virus-Related Risky Behavior," Journal of Law and Economics, University of Chicago Press, vol. 53(4), pages 741-782.
    6. Francis, Andrew M. & Mialon, Hugo M. & Peng, Handie, 2012. "In sickness and in health: Same-sex marriage laws and sexually transmitted infections," Social Science & Medicine, Elsevier, vol. 75(8), pages 1329-1341.
    7. Francis, Andrew M., 2008. "The economics of sexuality: The effect of HIV/AIDS on homosexual behavior in the United States," Journal of Health Economics, Elsevier, vol. 27(3), pages 675-689, May.
    8. Bae, Yong-Kyun, 2011. "Primary Seat Belt Laws and Offsetting Behavior: Empirical Evidence from Individual Accident Data," MPRA Paper 30443, University Library of Munich, Germany.
    9. James Berry & Greg Fischer & Raymond Guiteras, 2020. "Eliciting and Utilizing Willingness to Pay: Evidence from Field Trials in Northern Ghana," Journal of Political Economy, University of Chicago Press, vol. 128(4), pages 1436-1473.
    10. Gabriel Picone & Robyn Kibler & Bénédicte H. Apouey, 2017. "Malaria Prevalence, Indoor Residual Spraying, and Insecticide Treated Net Usage in Sub-Saharan Africa," Journal of African Development, African Finance and Economic Association (AFEA), vol. 19(2), pages 19-32.
    11. Bae, Yong-Kyun, 2013. "Primary Seat-Belt Laws and Driver Behavior: Evidence from Accident Data," MPRA Paper 49823, University Library of Munich, Germany, revised 15 Sep 2013.
    12. Donald N. Dewees, 2016. "Are Automated Vehicles Coming at the Right Speed?," Working Papers tecipa-564, University of Toronto, Department of Economics.
    13. Cronin, Christopher J. & Evans, William N., 2021. "Total shutdowns, targeted restrictions, or individual responsibility: How to promote social distancing in the COVID-19 Era?," Journal of Health Economics, Elsevier, vol. 79(C).
    14. Liang, Yuanning, 2020. "Do Safety Inspections Improve Safety? Evidence from the Safety Inspection Program for Commercial Motor Vehicles," 2020 Annual Meeting, July 26-28, Kansas City, Missouri 304312, Agricultural and Applied Economics Association.
    15. Goodkin-Gold, Matthew & Kremer, Michael & Snyder, Christopher M. & Williams, Heidi, 2022. "Optimal vaccine subsidies for endemic diseases," International Journal of Industrial Organization, Elsevier, vol. 84(C).
    16. Rossi, Pauline & Villar, Paola, 2020. "Private health investments under competing risks: Evidence from malaria control in Senegal," Journal of Health Economics, Elsevier, vol. 73(C).
    17. Talamàs, Eduard & Vohra, Rakesh, 2020. "Free and perfectly safe but only partially effective vaccines can harm everyone," Games and Economic Behavior, Elsevier, vol. 122(C), pages 277-289.
    18. Liang, Yuanning, 2023. "Do Safety Inspections Improve Safety? Evidence from the Roadside Inspection Program for Commercial Vehicles," 2023 Annual Meeting, July 23-25, Washington D.C. 335618, Agricultural and Applied Economics Association.
    19. Áureo De Paula & Gil Shapira & Petra E. Todd, 2014. "How Beliefs About Hiv Status Affect Risky Behaviors: Evidence From Malawi," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 29(6), pages 944-964, September.
    20. Mannberg, Andréa, 2012. "Risk and rationalization—The role of affect and cognitive dissonance for sexual risk taking," European Economic Review, Elsevier, vol. 56(6), pages 1325-1337.
    21. Carnehl, Christoph & Fukuda, Satoshi & Kos, Nenad, 2023. "Epidemics with behavior," Journal of Economic Theory, Elsevier, vol. 207(C).

    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

    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:eee:deveco:v:106:y:2014:i:c:p:78-91. 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: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/devec .

    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.