IDEAS home Printed from https://ideas.repec.org/p/nbr/nberwo/28716.html
   My bibliography  Save this paper

Knowledge, Stigma, and HIV Testing: An Analysis of a Widespread HIV/AIDS Program

Author

Listed:
  • Dean Yang
  • James Allen IV
  • Arlete Mahumane
  • James Riddell IV
  • Hang Yu

Abstract

Using randomized methodologies, we study a common community HIV/AIDS program that seeks to promote HIV testing by improving knowledge and reducing stigmatizing attitudes. Contrary to expectations, the program has a substantial negative effect on HIV testing rates. We provide evidence of likely mechanisms behind the program’s negative effect: it inadvertently increased misinformation about HIV transmission methods, and worsened HIV-related stigmatizing attitudes. Subsequent household-level randomized treatments providing correct information and addressing stigma concerns counteract the program’s negative effect on HIV testing. These findings highlight the importance of improving knowledge and alleviating stigma concerns when promoting HIV testing.

Suggested Citation

  • Dean Yang & James Allen IV & Arlete Mahumane & James Riddell IV & Hang Yu, 2021. "Knowledge, Stigma, and HIV Testing: An Analysis of a Widespread HIV/AIDS Program," NBER Working Papers 28716, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:28716
    Note: DEV EH
    as

    Download full text from publisher

    File URL: http://www.nber.org/papers/w28716.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. John A. List & Azeem M. Shaikh & Yang Xu, 2019. "Multiple hypothesis testing in experimental economics," Experimental Economics, Springer;Economic Science Association, vol. 22(4), pages 773-793, December.
    2. Furuya, Kaku, 2002. "A socio-economic model of stigma and related social problems," Journal of Economic Behavior & Organization, Elsevier, vol. 48(3), pages 281-290, July.
    3. Stefano DellaVigna & Nicholas Otis & Eva Vivalt, 2020. "Forecasting the Results of Experiments: Piloting an Elicitation Strategy," AEA Papers and Proceedings, American Economic Association, vol. 110, pages 75-79, May.
    4. Julian Jamison & Dean Karlan & Pia Raffler, 2013. "Mixed Method Evaluation of a Passive mHealth Sexual Information Testing Service in Uganda," Working Papers 1025, Economic Growth Center, Yale University.
    5. Toman Barsbai & Victoria Licuanan & Andreas Steinmayr & Erwin Tiongson & Dean Yang, 2020. "Information and the Acquisition of Social Network Connections," NBER Working Papers 27346, National Bureau of Economic Research, Inc.
    6. Anne Case & Christina Paxson & Joseph Ableidinger, 2004. "Orphans in Africa: parental death, poverty, and school enrollment," Demography, Springer;Population Association of America (PAA), vol. 41(3), pages 483-508, August.
    7. David Evans & Edward Miguel, 2007. "Orphans and schooling in africa: a longitudinal analysis," Demography, Springer;Population Association of America (PAA), vol. 44(1), pages 35-57, February.
    8. Leonardo Bursztyn & Alessandra L. González & David Yanagizawa-Drott, 2020. "Misperceived Social Norms: Women Working Outside the Home in Saudi Arabia," American Economic Review, American Economic Association, vol. 110(10), pages 2997-3029, October.
    9. O'Flaherty, Brendan & Sethi, Rajiv, 2008. "Racial stereotypes and robbery," Journal of Economic Behavior & Organization, Elsevier, vol. 68(3-4), pages 511-524, December.
    10. Bharadwaj, Prashant & Pai, Mallesh M. & Suziedelyte, Agne, 2017. "Mental health stigma," Economics Letters, Elsevier, vol. 159(C), pages 57-60.
    11. 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.
    12. Sarojini Hirshleifer & David McKenzie & Rita Almeida & Cristobal Ridao‐Cano, 2016. "The Impact of Vocational Training for the Unemployed: Experimental Evidence from Turkey," Economic Journal, Royal Economic Society, vol. 126(597), pages 2115-2146, November.
    13. Ssewamala, Fred M. & Han, Chang-Keun & Neilands, Torsten B., 2009. "Asset ownership and health and mental health functioning among AIDS-orphaned adolescents: Findings from a randomized clinical trial in rural Uganda," Social Science & Medicine, Elsevier, vol. 69(2), pages 191-198, July.
    14. Moffitt, Robert, 1983. "An Economic Model of Welfare Stigma," American Economic Review, American Economic Association, vol. 73(5), pages 1023-1035, December.
    15. 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.
    16. repec:pri:cheawb:case_paxson_orphansafrica is not listed on IDEAS
    17. Vishwanath, Tara, 1989. "Job Search, Stigma Effect, and Escape Rate from Unemployment," Journal of Labor Economics, University of Chicago Press, vol. 7(4), pages 487-502, October.
    18. Allen, James & Mahumane, Arlete & Riddell, James & Rosenblat, Tanya & Yang, Dean & Yu, Hang, 2022. "Teaching and incentives: Substitutes or complements?," Economics of Education Review, Elsevier, vol. 91(C).
    19. repec:pri:rpdevs:case_paxson_orphansafrica.pdf is not listed on IDEAS
    20. Sarah Baird & Craig McIntosh & Berk Özler, 2011. "Cash or Condition? Evidence from a Cash Transfer Experiment," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 126(4), pages 1709-1753.
    21. 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.
    22. Daniel Zizzo, 2010. "Experimenter demand effects in economic experiments," Experimental Economics, Springer;Economic Science Association, vol. 13(1), pages 75-98, March.
    23. 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.
    24. Moulton, Brent R., 1986. "Random group effects and the precision of regression estimates," Journal of Econometrics, Elsevier, vol. 32(3), pages 385-397, August.
    25. 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.
    26. Friedman, Willa Helterline, 2018. "Antiretroviral drug access and behavior change," Journal of Development Economics, Elsevier, vol. 135(C), pages 392-411.
    27. Delavande, Adeline & Sampaio, Mafalda & Sood, Neeraj, 2014. "HIV-related social intolerance and risky sexual behavior in a high HIV prevalence environment," Social Science & Medicine, Elsevier, vol. 111(C), pages 84-93.
    28. Jonathan de Quidt & Johannes Haushofer & Christopher Roth, 2018. "Measuring and Bounding Experimenter Demand," American Economic Review, American Economic Association, vol. 108(11), pages 3266-3302, November.
    29. repec:pri:rpdevs:case_paxson_orphansafrica is not listed on IDEAS
    30. 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.
    31. George A. Akerlof & Janet L. Yellen & Michael L. Katz, 1996. "An Analysis of Out-of-Wedlock Childbearing in the United States," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 277-317.
    32. 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.
    33. Adeline Delavande & Hans-Peter Kohler, 2012. "The Impact of HIV Testing on Subjective Expectations and Risky Behavior in Malawi," Demography, Springer;Population Association of America (PAA), vol. 49(3), pages 1011-1036, August.
    34. James Allen IV & Arlete Mahumane & James Riddell IV & Tanya Rosenblat & Dean Yang & Hang Yu, 2021. "Correcting Perceived Social Distancing Norms to Combat COVID-19," NBER Working Papers 28651, National Bureau of Economic Research, Inc.
    35. 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.
    36. Erick Gong, 2015. "HIV Testing and Risky Sexual Behaviour," Economic Journal, Royal Economic Society, vol. 125(582), pages 32-60, February.
    37. Ishida, Junichiro, 2003. "The role of social norms in a model of marriage and divorce," Journal of Economic Behavior & Organization, Elsevier, vol. 51(1), pages 131-142, May.
    38. repec:pri:cheawb:case_paxson_orphansafrica.pdf is not listed on IDEAS
    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. Christopher Roth & Peter Schwardmann & Egon Tripodi, 2024. "Depression Stigma," Rationality and Competition Discussion Paper Series 499, CRC TRR 190 Rationality and Competition.
    2. Allen, James & Mahumane, Arlete & Riddell, James & Rosenblat, Tanya & Yang, Dean & Yu, Hang, 2022. "Teaching and incentives: Substitutes or complements?," Economics of Education Review, Elsevier, vol. 91(C).
    3. 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. 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).
    2. David Mmopelwa & Oliver Morrissey & Trudy Owens, 2021. "HIV/AIDS and sexual behaviour in Botswana," Discussion Papers 2021-03, University of Nottingham, CREDIT.
    3. 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.
    4. 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).
    5. 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).
    6. Friedman, Willa Helterline, 2018. "Antiretroviral drug access and behavior change," Journal of Development Economics, Elsevier, vol. 135(C), pages 392-411.
    7. Bharadwaj, Prashant & Pai, Mallesh M. & Suziedelyte, Agne, 2017. "Mental health stigma," Economics Letters, Elsevier, vol. 159(C), pages 57-60.
    8. Kecinski, Maik & Kerley Keisner, Deborah & Messer, Kent D. & Schulze, William D., 2016. "Stigma mitigation and the importance of redundant treatments," Journal of Economic Psychology, Elsevier, vol. 54(C), pages 44-52.
    9. Maik Kecinski & Deborah Kerley Keisner & Kent D. Messer & William D. Schulze, 2018. "Measuring Stigma: The Behavioral Implications of Disgust," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 70(1), pages 131-146, May.
    10. Daniela Iorio & Raül Santaeulàlia-Llopis, 2011. "Education, HIV Status, and Risky Sexual Behavior: How Much Does the Stage of the HIV Epidemic Matter?," Working Papers 624, Barcelona School of Economics.
    11. 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.
    12. 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.
    13. Dupas, Pascaline & Huillery, Elise & Seban, Juliette, 2018. "Risk information, risk salience, and adolescent sexual behavior: Experimental evidence from Cameroon," Journal of Economic Behavior & Organization, Elsevier, vol. 145(C), pages 151-175.
    14. Allen, James & Mahumane, Arlete & Riddell, James & Rosenblat, Tanya & Yang, Dean & Yu, Hang, 2022. "Teaching and incentives: Substitutes or complements?," Economics of Education Review, Elsevier, vol. 91(C).
    15. Gianmarco Daniele & Andrea F.M. Martinangeli & Francesco Passarelli & Willem Sas & Lisa Windsteiger, 2020. "When Distrust Goes Viral: Causal Effects of Covid-19 on European Political Attitudes," CESifo Working Paper Series 8804, CESifo.
    16. Gianmarco Daniele & Andrea F.M. Martinangeli & Francesco Passarelli & Willem Sas & Lisa Windsteiger, 2020. "When Economic and Health Crises Collide: The Effect of Covid-19 on Political Attitudes," Working Papers tax-mpg-rps-2020-18_2, Max Planck Institute for Tax Law and Public Finance.
    17. Gani Aldashev & Jean-Marie Baland, 2012. "Awareness and AIDS: A Political Economy Perspective," Working Papers 1204, University of Namur, Department of Economics.
    18. 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.
    19. Herrera Catalina & E. Sahn David, 2017. "Working Paper 281 - Early Childbearing, School Attainment and Cognitive Skills," Working Paper Series 2398, African Development Bank.
    20. Cohen, Jessica & Saran, Indrani, 2018. "The impact of packaging and messaging on adherence to malaria treatment: Evidence from a randomized controlled trial in Uganda," Journal of Development Economics, Elsevier, vol. 134(C), pages 68-95.

    More about this item

    JEL classification:

    • D10 - Microeconomics - - Household Behavior - - - General
    • D80 - Microeconomics - - Information, Knowledge, and Uncertainty - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

    NEP fields

    This paper has been announced in the following NEP Reports:

    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:nbr:nberwo:28716. 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: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/nberrus.html .

    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.