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Antiretroviral therapy and demand for HIV testing: Evidence from Zambia

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  • Wilson, Nicholas

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 appears to have increased HIV testing rates by upwards of 50 percent, the ART allocation process may have 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.

Suggested Citation

  • Wilson, Nicholas, 2016. "Antiretroviral therapy and demand for HIV testing: Evidence from Zambia," Economics & Human Biology, Elsevier, vol. 21(C), pages 221-240.
  • Handle: RePEc:eee:ehbiol:v:21:y:2016:i:c:p:221-240
    DOI: 10.1016/j.ehb.2016.02.003
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    References listed on IDEAS

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    Citations

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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. Rebecca Myerson & Darius Lakdawalla & Lisandro D. Colantonio & Monika Safford & David Meltzer, 2018. "Effects of expanding health screening on treatment – What should we expect? What can we learn?," Working Papers 2018-014, Human Capital and Economic Opportunity Working Group.
    3. repec:eee:ehbiol:v:28:y:2018:i:c:p:79-91 is not listed on IDEAS
    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.
    5. 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.
    6. Aureo de Paula & Gil Shapira & Petra E. Todd, 2008. "How Beliefs About HIV Status affect Risky Behaviors: Evidence From Malawi, Second Version," PIER Working Paper Archive 08-041, Penn Institute for Economic Research, Department of Economics, University of Pennsylvania, revised 02 Dec 2008.
    7. Wilson, Nicholas, 2015. "Child mortality risk and fertility: Evidence from prevention of mother-to-child transmission of HIV," Journal of Development Economics, Elsevier, vol. 116(C), pages 74-88.

    More about this item

    Keywords

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

    JEL classification:

    • D45 - Microeconomics - - Market Structure, Pricing, and Design - - - Rationing; Licensing
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • O12 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Microeconomic Analyses of Economic Development

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