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HIV Breakthroughs and Risk Sexual Behavior

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  • Dana Goldman
  • Darius Lakdawalla
  • Neeraj Sood

Abstract

Recent breakthroughs in the treatment of HIV have coincided with an increase in infection rates and an eventual slowing of reductions in HIV mortality. These trends may be causally related, if treatment improves the health and functional status of HIV+ individuals and allows them to engage in more sexual risk-taking. We examine this hypothesis empirically using access to health insurance as an instrument for treatment status. We find that treatment results in more sexual risk-taking by HIV+ adults, and possibly more of other risky behaviors like drug abuse. This relationship implies that breakthroughs in treating an incurable disease like HIV can increase precautionary behavior by the uninfected and thus reduce welfare. We also show that, in the presence of this effect, treatment and prevention are social complements for incurable diseases, even though they are substitutes for curable ones. Finally, there is less under-provision of treatment for an incurable disease than a curable one, because of the negative externalities associated with treating an incurable disease.

Suggested Citation

  • Dana Goldman & Darius Lakdawalla & Neeraj Sood, 2004. "HIV Breakthroughs and Risk Sexual Behavior," NBER Working Papers 10516, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:10516
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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.
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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. Andrew M. Jones, 2007. "Identification of treatment effects in Health Economics," Health Economics, John Wiley & Sons, Ltd., vol. 16(11), pages 1127-1131.
    5. 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.
    6. 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.
    7. Wilson, Nicholas, 2016. "Antiretroviral therapy and demand for HIV testing: Evidence from Zambia," Economics & Human Biology, Elsevier, vol. 21(C), pages 221-240.
    8. 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.
    9. Xue Qiao, 2012. "Unsafe sex, AIDS and development," Journal of Economics, Springer, vol. 105(3), pages 263-279, April.
    10. 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.
    11. 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.
    12. Barron, Kai & Gamboa, Luis F. & Rodriguez-Lesmes, Paul, 2017. "Behavioural response to a sudden health risk: Dengue and educational outcomes in Colombia," Discussion Papers, Research Unit: Economics of Change SP II 2017-306, Social Science Research Center Berlin (WZB).
    13. 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.
    14. 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.
    15. 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.
    16. 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.
    17. 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.
    18. 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.
    19. 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.
    20. 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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