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Antiretroviral drug access and behavior change

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  • Friedman, Willa Helterline

Abstract

Assessing the impact of antiretroviral-drug access on future HIV infections in Sub-Saharan Africa requires identification of the behavioral response. This paper combines geocoded information about the timing of introduction of ARVs in Kenyan health facilities with population surveys to estimate the impact of proximity to ARV providers on adolescent risky sexual behavior. A variety of difference-in-difference strategies yield a range of estimates of behavioral effects on pregnancy rates and self-reported sexual activity among 15-18 year-olds in areas where ARVs were introduced, from small to quite large. A simulation combining estimated behavioral responses with medical evidence regarding HIV transmission suggests increasing ARV access will reduce new HIV infections even with a very large increases in risk-taking.

Suggested Citation

  • Friedman, Willa Helterline, 2018. "Antiretroviral drug access and behavior change," Journal of Development Economics, Elsevier, vol. 135(C), pages 392-411.
    • Handle: RePEc:eee:deveco:v:135:y:2018:i:c:p:392-411
    DOI: 10.1016/j.jdeveco.2018.07.011
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    Cited by:

    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. Yao Yao, 2022. "Fertility and HIV Risk in Africa," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 45, pages 109-133, July.
    3. 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.
    4. Adrienne M. Lucas & Nicholas L. Wilson, 2018. "Can At-Scale Drug Provision Improve the Health of the Targeted in Sub-Saharan Africa?," American Journal of Health Economics, University of Chicago Press, vol. 4(3), pages 358-382, Summer.
    5. Guimarães, Luís, 2021. "Antibody tests: They are more important than we thought," Journal of Mathematical Economics, Elsevier, vol. 93(C).
    6. Herrera-Almanza, Catalina & Rosales-Rueda, Maria F., 2023. "Community-based health programs and child vaccinations: Evidence from Madagascar," World Development, Elsevier, vol. 170(C).
    7. Luke Chicoine & Emily Lyons & Alexia Sahue, 2021. "The impact of HIV/AIDS on human capital investment in Sub‐Saharan Africa: New evidence," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 36(6), pages 842-852, September.
    8. Victoria Baranov & Hans-Peter Kohler, 2018. "The Impact of AIDS Treatment on Savings and Human Capital Investment in Malawi," American Economic Journal: Applied Economics, American Economic Association, vol. 10(1), pages 266-306, January.
    9. Wilson Nicholas, 2019. "The World’s Oldest Profession? Employment-Age Profiles from the Transactional Sex Market," IZA Journal of Labor Policy, Sciendo & Forschungsinstitut zur Zukunft der Arbeit GmbH (IZA), vol. 9(1), pages 1-17, June.
    10. Adrienne M. Lucas & Nicholas L. Wilson, 2013. "Adult Antiretroviral Therapy and Child Health: Evidence from Scale-Up in Zambia," American Economic Review, American Economic Association, vol. 103(3), pages 456-461, May.
    11. Lucas, Adrienne M. & Chidothe, Margaret & Wilson, Nicholas L., 2019. "Effects of adult health interventions at scale on children’s schooling: Evidence from antiretroviral therapy in Zambia," Economics of Education Review, Elsevier, vol. 72(C), pages 107-120.
    12. 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).
    13. 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.
    14. 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.
    15. Herrera Catalina & E. Sahn David, 2017. "Working Paper 281 - Early Childbearing, School Attainment and Cognitive Skills," Working Paper Series 2398, African Development Bank.
    16. Herrera-Almanza, Catalina & McCarthey, Aine Seitz, 2023. "Disparities in Spousal Desired Fertility and Land Tenure Expectations: Experimental Evidence from Rural Tanzania," 2024 Allied Social Sciences Association (ASSA) Annual Meeting, January 5-7, 2024, San Antonio, Texas 339077, Agricultural and Applied Economics Association.
    17. David Mmopelwa & Oliver Morrissey & Trudy Owens, 2021. "HIV/AIDS and sexual behaviour in Botswana," Discussion Papers 2021-03, University of Nottingham, CREDIT.
    18. Catalina Herrera Almanza & David E. Sahn, 2018. "Early Childbearing, School Attainment, and Cognitive Skills: Evidence From Madagascar," Demography, Springer;Population Association of America (PAA), vol. 55(2), pages 643-668, April.

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    More about this item

    Keywords

    I15; I18; J13; O15;
    All these keywords.

    JEL classification:

    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration

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