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HIV Breakthroughs and Risky Sexual Behavior

Author

Listed:
  • Darius Lakdawalla
  • Neeraj Sood
  • Dana Goldman

Abstract

Recent HIV treatment breakthroughs have lowered HIV mortality in the United States, but have also coincided with increased HIV incidence. We argue that these trends are causally linked, because new treatments have improved health and survival for the HIV +, increased their sexual activity, and thus facilitated HIV's spread. Using variation in state-level Medicaid eligibility rules as an instrument for HIV treatment, we find that treating HIV + individuals more than doubles their number of sex partners. A change of this magnitude would increase infection risk by at least 44 percent for the HIV-negative and likely have lowered their expected welfare.

Suggested Citation

  • Darius Lakdawalla & Neeraj Sood & Dana Goldman, 2006. "HIV Breakthroughs and Risky Sexual Behavior," The Quarterly Journal of Economics, Oxford University Press, vol. 121(3), pages 1063-1102.
  • Handle: RePEc:oup:qjecon:v:121:y:2006:i:3:p:1063-1102.
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    File URL: http://hdl.handle.net/10.1162/qjec.121.3.1063
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    References listed on IDEAS

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    1. Philipson, Tomas, 2000. "Economic epidemiology and infectious diseases," Handbook of Health Economics,in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 33, pages 1761-1799 Elsevier.
    2. Nelson, Charles R & Startz, Richard, 1990. "Some Further Results on the Exact Small Sample Properties of the Instrumental Variable Estimator," Econometrica, Econometric Society, vol. 58(4), pages 967-976, July.
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    Cited by:

    1. Adeline Delavande, 2012. "HIV/AIDS-related Expectations and Risky Sexual Behavior in Malawi," 2012 Meeting Papers 90, Society for Economic Dynamics.
    2. Jeremy Greenwood & Philipp Kircher & Cezar Santos & Michèle Tertilt, 2013. "An Equilibrium Model of the African HIV/AIDS Epidemic," NBER Working Papers 18953, National Bureau of Economic Research, Inc.
    3. Immordino, G. & Russo, F.F., 2015. "Regulating prostitution: A health risk approach," Journal of Public Economics, Elsevier, vol. 121(C), pages 14-31.
    4. Jean-Claude Berthélemy & Victor Doubliez & Josselin Thuilliez, 2015. "Prevention or treatment? The introduction of a new antimalarial drug in Angola," Université Paris1 Panthéon-Sorbonne (Post-Print and Working Papers) halshs-01244406, HAL.
    5. Fischer, Gregory & Berry, James & Guiteras, Raymond, 2012. "Eliciting and utilizing willingness to pay: evidence from field trials in Northern Ghana," LSE Research Online Documents on Economics 47913, London School of Economics and Political Science, LSE Library.
    6. Andrew M. Jones, 2007. "Identification of treatment effects in Health Economics," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1127-1131.
    7. Betsey Stevenson & Justin Wolfers, 2007. "Marriage and Divorce: Changes and their Driving Forces," Journal of Economic Perspectives, American Economic Association, vol. 21(2), pages 27-52, Spring.
    8. Anup Malani & Tomas J. Philipson, 2011. "Can Medical Progress be Sustained? Implications of the Link Between Development and Output Markets," NBER Working Papers 17011, National Bureau of Economic Research, Inc.
    9. Wilson, Nicholas, 2016. "Antiretroviral therapy and demand for HIV testing: Evidence from Zambia," Economics & Human Biology, Elsevier, vol. 21(C), pages 221-240.
    10. Jay Bhattacharya & M. Kate Bundorf & Noemi Pace & Neeraj Sood, 2011. "Does Health Insurance Make You Fat?," NBER Chapters,in: Economic Aspects of Obesity, pages 35-64 National Bureau of Economic Research, Inc.
    11. Xue Qiao, 2012. "Unsafe sex, AIDS and development," Journal of Economics, Springer, vol. 105(3), pages 263-279, April.
    12. Hussey, Andrew & Nikolsko-Rzhevskyy, Alex & Walker, Jay, 2010. "AIDing Contraception: HIV and Recent Trends in Abortion Rates," MPRA Paper 20895, University Library of Munich, Germany.
    13. Bennett, Daniel & Chiang, Chun-Fang & Malani, Anup, 2015. "Learning during a crisis: The SARS epidemic in Taiwan," Journal of Development Economics, Elsevier, vol. 112(C), pages 1-18.
    14. Kai Barron & Luis F. Gamboa & Paul Rodríguez-Lesmes, 2019. "Behavioural Response to a Sudden Health Risk: Dengue and Educational Outcomes in Colombia," Journal of Development Studies, Taylor & Francis Journals, vol. 55(4), pages 620-644, April.
    15. 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.
    16. repec:eee:jeborg:v:156:y:2018:i:c:p:225-251 is not listed on IDEAS
    17. Neeraj Sood & Yanyu Wu, 2013. "The Impact of Insurance and HIV Treatment Technology on HIV Testing," NBER Working Papers 19397, National Bureau of Economic Research, Inc.
    18. repec:eee:deveco:v:135:y:2018:i:c:p:392-411 is not listed on IDEAS
    19. Jackson, C. Kirabo & Owens, Emily Greene, 2011. "One for the road: Public transportation, alcohol consumption, and intoxicated driving," Journal of Public Economics, Elsevier, vol. 95(1-2), pages 106-121, February.
    20. 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.
    21. David Canning, 2006. "The Economics of HIV/AIDS in Low-Income Countries: The Case for Prevention," Journal of Economic Perspectives, American Economic Association, vol. 20(3), pages 121-142, Summer.
    22. 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.
    23. 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.
    24. Doleac, Jennifer & Mukherjee, Anita, 2018. "The Moral Hazard of Lifesaving Innovations: Naloxone Access, Opioid Abuse, and Crime," IZA Discussion Papers 11489, Institute of Labor Economics (IZA).
    25. Sabine Liebenehm & Bernard Bett & Cristobal Verdugo & Mohamed Said, 2016. "Optimal Drug Control under Risk of Drug Resistance – The Case of African Animal Trypanosomosis," Journal of Agricultural Economics, Wiley Blackwell, vol. 67(2), pages 510-533, June.

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    JEL classification:

    • I1 - Health, Education, and Welfare - - Health

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