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Willingness-to-accept reductions in HIV risks: conditional economic incentives in Mexico

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  • Omar Galárraga
  • Sandra Sosa-Rubí
  • César Infante
  • Paul Gertler
  • Stefano Bertozzi

Abstract

The objective of this study was to measure willingness-to-accept (WTA) reductions in risks for HIV and other sexually transmitted infections (STI) using conditional economic incentives (CEI) among men who have sex with men (MSM), including male sex workers (MSW) in Mexico City. A survey experiment was conducted with 1,745 MSM and MSW (18–25 years of age) who received incentive offers to decide first whether to accept monthly prevention talks and STI testing; and then a second set of offers to accept to stay free of STIs (verified by quarterly biological testing). The survey used random-starting-point and iterative offers. WTA was estimated with a maximum likelihood double-bounded dichotomous choice model. The average acceptance probabilities were: 73.9 % for the monthly model, and 80.4 % for the quarterly model. The incentive-elasticity of participation in the monthly model was 0.222, and 0.515 in the quarterly model. For a combination program with monthly prevention talks, and staying free of curable STI, the implied WTA was USD$ 288 per person per year, but it was lower for MSW: USD$ 156 per person per year. Thus, some of the populations at highest risk of HIV infection (MSM and MSW) seem well disposed to participate in a CEI program for HIV and STI prevention in Mexico. The average WTA estimate is within the range of feasible allocations for prevention in the local context. Given the potential impact, Mexico, a leader in conditional cash transfers for human development and poverty reduction, could extend that successful model to targeted HIV/STI prevention. Copyright Springer-Verlag Berlin Heidelberg 2014

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  • Omar Galárraga & Sandra Sosa-Rubí & César Infante & Paul Gertler & Stefano Bertozzi, 2014. "Willingness-to-accept reductions in HIV risks: conditional economic incentives in Mexico," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(1), pages 41-55, January.
  • Handle: RePEc:spr:eujhec:v:15:y:2014:i:1:p:41-55
    DOI: 10.1007/s10198-012-0447-y
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    Cited by:

    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. Jan Ostermann & Derek Brown & Axel Mühlbacher & Bernard Njau & Nathan Thielman, 2015. "Would you test for 5000 Shillings? HIV risk and willingness to accept HIV testing in Tanzania," Health Economics Review, Springer, vol. 5(1), pages 1-11, December.
    3. Terris-Prestholt, Fern & Windmeijer, Frank, 2016. "How to sell a condom? The impact of demand creation tools on male and female condom sales in resource limited settings," Journal of Health Economics, Elsevier, vol. 48(C), pages 107-120.
    4. Cooper, Jan E. & Dow, William H. & de Walque, Damien & Keller, Ann C. & McCoy, Sandra I. & Fernald, Lia C.H. & Balampama, Marianna P. & Kalolella, Admirabilis & Packel, Laura J. & Wechsberg, Wendee M., 2017. "Female sex workers use power over their day-to-day lives to meet the condition of a conditional cash transfer intervention to incentivize safe sex," Social Science & Medicine, Elsevier, vol. 181(C), pages 148-157.

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    More about this item

    Keywords

    Willingness-to-accept; Conditional economic incentive; HIV/AIDS and STI prevention; Contingency management/conditional cash transfer; Mexico; I18; O15; C93; C33; C35;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration
    • C93 - Mathematical and Quantitative Methods - - Design of Experiments - - - Field Experiments
    • C33 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Models with Panel Data; Spatio-temporal Models
    • C35 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Discrete Regression and Qualitative Choice Models; Discrete Regressors; Proportions

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