IDEAS home Printed from https://ideas.repec.org/a/eee/deveco/v159y2022ics0304387822001353.html
   My bibliography  Save this article

Love in the time of HIV: How beliefs about externalities impact health behavior

Author

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

Abstract

Despite the widespread availability of lifesaving antiretroviral drugs, demand for HIV testing is low. Antiretrovirals have a positive externality: they prevent HIV transmission. We use an experiment in Malawi to show that informing communities about this externality can shift beliefs and increase HIV testing in the short term, with a larger effect for sexually-active demographics. We also see a change in attitudes toward sexual partners taking antiretrovirals. Learning about a positive externality can increase demand for healthcare.

Suggested Citation

  • 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).
  • Handle: RePEc:eee:deveco:v:159:y:2022:i:c:s0304387822001353
    DOI: 10.1016/j.jdeveco.2022.102993
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0304387822001353
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.jdeveco.2022.102993?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. Jean Tirole & Roland Bénabou, 2006. "Incentives and Prosocial Behavior," American Economic Review, American Economic Association, vol. 96(5), pages 1652-1678, December.
    2. 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.
    3. Oster, Emily, 2012. "HIV and sexual behavior change: Why not Africa?," Journal of Health Economics, Elsevier, vol. 31(1), pages 35-49.
    4. Alberto Abadie & Susan Athey & Guido W Imbens & Jeffrey M Wooldridge, 2023. "When Should You Adjust Standard Errors for Clustering?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 138(1), pages 1-35.
    5. de Walque, Damien & Gertler, Paul J. & Bautista-Arredondo, Sergio & Kwan, Ada & Vermeersch, Christel & de Dieu Bizimana, Jean & Binagwaho, Agnès & Condo, Jeanine, 2015. "Using provider performance incentives to increase HIV testing and counseling services in Rwanda," Journal of Health Economics, Elsevier, vol. 40(C), pages 1-9.
    6. 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.
    7. Jeremy Greenwood & Philipp Kircher & Cezar Santos & Michèle Tertilt, 2019. "An Equilibrium Model of the African HIV/AIDS Epidemic," Econometrica, Econometric Society, vol. 87(4), pages 1081-1113, July.
    8. Lacetera, Nicola & Macis, Mario, 2010. "Social image concerns and prosocial behavior: Field evidence from a nonlinear incentive scheme," Journal of Economic Behavior & Organization, Elsevier, vol. 76(2), pages 225-237, November.
    9. 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.
    10. 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.
    11. Friedman, Willa Helterline, 2018. "Antiretroviral drug access and behavior change," Journal of Development Economics, Elsevier, vol. 135(C), pages 392-411.
    12. Esther Duflo & Pascaline Dupas & Michael Kremer, 2015. "Education, HIV, and Early Fertility: Experimental Evidence from Kenya," American Economic Review, American Economic Association, vol. 105(9), pages 2757-2797, September.
    13. Banerjee,Abhijit & La Ferrara,Eliana & Orozco Olvera,Victor Hugo, 2019. "The Entertaining Way to Behavioral Change : Fighting HIV with MTV," Policy Research Working Paper Series 8998, The World Bank.
    14. Miriam Bruhn & David McKenzie, 2009. "In Pursuit of Balance: Randomization in Practice in Development Field Experiments," American Economic Journal: Applied Economics, American Economic Association, vol. 1(4), pages 200-232, October.
    15. Angotti, Nicole & Bula, Agatha & Gaydosh, Lauren & Kimchi, Eitan Zeev & Thornton, Rebecca L. & Yeatman, Sara E., 2009. "Increasing the acceptability of HIV counseling and testing with three C's: Convenience, confidentiality and credibility," Social Science & Medicine, Elsevier, vol. 68(12), pages 2263-2270, June.
    16. 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.
    17. Kaler, Amy & Angotti, Nicole & Ramaiya, Astha, 2016. "“They are looking just the same”: Antiretroviral treatment as social danger in rural Malawi," Social Science & Medicine, Elsevier, vol. 167(C), pages 71-78.
    18. Ashraf, Nava & Bandiera, Oriana & Jack, B. Kelsey, 2014. "No margin, no mission? A field experiment on incentives for public service delivery," Journal of Public Economics, Elsevier, vol. 120(C), pages 1-17.
    19. 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.
    20. 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.
    21. 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.
    22. Erick Gong, 2015. "HIV Testing and Risky Sexual Behaviour," Economic Journal, Royal Economic Society, vol. 125(582), pages 32-60, February.
    23. 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.
    24. Godlonton, Susan & Thornton, Rebecca, 2012. "Peer effects in learning HIV results," Journal of Development Economics, Elsevier, vol. 97(1), pages 118-129.
    25. Adeline Delavande & Hans-Peter Kohler, 2009. "Subjective expectations in the context of HIV/AIDS in Malawi," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 20(31), pages 817-875.
    26. Abhijit Banerjee & Marcella Alsan & Emily Breza & Arun G. Chandrasekhar & Abhijit Chowdhury & Esther Duflo & Paul Goldsmith-Pinkham & Benjamin A. Olken, 2020. "Messages on COVID-19 Prevention in India Increased Symptoms Reporting and Adherence to Preventive Behaviors Among 25 Million Recipients with Similar Effects on Non-recipient Members of Their Communiti," NBER Working Papers 27496, National Bureau of Economic Research, Inc.
    27. Alan S. Perelson & Paulina Essunger & Yunzhen Cao & Mika Vesanen & Arlene Hurley & Kalle Saksela & Martin Markowitz & David D. Ho, 1997. "Decay characteristics of HIV-1-infected compartments during combination therapy," Nature, Nature, vol. 387(6629), pages 188-191, May.
    28. Caplin, Andrew & Eliaz, Kfir, 2003. "AIDS Policy and Psychology: A Mechanism-Design Approach," RAND Journal of Economics, The RAND Corporation, vol. 34(4), pages 631-646, Winter.
    29. Susan Godlonton & Alister Munthali & Rebecca Thornton, 2016. "Responding to Risk: Circumcision, Information, and HIV Prevention," The Review of Economics and Statistics, MIT Press, vol. 98(2), pages 333-349, May.
    30. Yeomans, Mike & Herberich, David, 2014. "An experimental test of the effect of negative social norms on energy-efficient investments," Journal of Economic Behavior & Organization, Elsevier, vol. 108(C), pages 187-197.
    31. Siwan Anderson, 2018. "Legal Origins and Female HIV," American Economic Review, American Economic Association, vol. 108(6), pages 1407-1439, June.
    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. Yu, Hang, 2023. "Social stigma as a barrier to HIV testing: Evidence from a randomized experiment in Mozambique," Journal of Development Economics, Elsevier, vol. 161(C).

    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. Cassidy, Rachel & Groot Bruinderink, Marije & Janssens, Wendy & Morsink, Karlijn, 2021. "The power to protect: Household bargaining and female condom use," Journal of Development Economics, Elsevier, vol. 153(C).
    2. 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.
    3. Friedman, Willa Helterline, 2018. "Antiretroviral drug access and behavior change," Journal of Development Economics, Elsevier, vol. 135(C), pages 392-411.
    4. 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).
    5. David Mmopelwa & Oliver Morrissey & Trudy Owens, 2021. "HIV/AIDS and sexual behaviour in Botswana," Discussion Papers 2021-03, University of Nottingham, CREDIT.
    6. Wilson, Nicholas, 2016. "Antiretroviral therapy and demand for HIV testing: Evidence from Zambia," Economics & Human Biology, Elsevier, vol. 21(C), pages 221-240.
    7. 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.
    8. Jeremy Greenwood & Philipp Kircher & Cezar Santos & Michèle Tertilt, 2019. "An Equilibrium Model of the African HIV/AIDS Epidemic," Econometrica, Econometric Society, vol. 87(4), pages 1081-1113, July.
    9. Bertocchi, Graziella & Dimico, Arcangelo, 2019. "The long-term determinants of female HIV infection in Africa: The slave trade, polygyny, and sexual behavior," Journal of Development Economics, Elsevier, vol. 140(C), pages 90-105.
    10. Hyuncheol Bryant Kim & Beliyou Haile & Taewha Lee, 2017. "Promotion and Persistence of HIV Testing and HIV/AIDS Knowledge: Evidence From a Randomized Controlled Trial in Ethiopia," Health Economics, John Wiley & Sons, Ltd., vol. 26(11), pages 1394-1411, November.
    11. 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.
    12. 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.
    13. 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.
    14. Francesco Capozza & Ingar Haaland & Christopher Roth & Johannes Wohlfart, 2021. "Studying Information Acquisition in the Field: A Practical Guide and Review," CEBI working paper series 21-15, University of Copenhagen. Department of Economics. The Center for Economic Behavior and Inequality (CEBI).
    15. 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.
    16. 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.
    17. Derksen, Laura & Kerwin, Jason Theodore & Reynoso, Natalia Ordaz & Sterck, Olivier, 2021. "Appointments: A More Effective Commitment Device for Health Behaviors," SocArXiv y8gh7, Center for Open Science.
    18. 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).
    19. 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.
    20. repec:hal:wpspec:info:hdl:2441/76npisrda99aop75h6fmi4vduu is not listed on IDEAS
    21. Cagé, Julia & Rueda, Valeria, 2020. "Sex and the mission: the conflicting effects of early Christian missions on HIV in sub-Saharan Africa," Journal of Demographic Economics, Cambridge University Press, vol. 86(3), pages 213-257, September.

    More about this item

    Keywords

    Health behavior; Externalities; Information; Experiment; HIV testing; Stigma;
    All these keywords.

    JEL classification:

    • D62 - Microeconomics - - Welfare Economics - - - Externalities
    • D83 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Search; Learning; Information and Knowledge; Communication; Belief; Unawareness
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

    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:159:y:2022:i:c:s0304387822001353. 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.