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How Beliefs about HIV Status Affect Risky Behaviors: Evidence from Malawi

Author

Listed:
  • Aureo de Paula

    () (Department of Economics, University of Pennsylvania)

  • Gil Shapira

    () (Department of Economics, University of Pennsylvania)

  • Petra Todd

    () (Department of Economics, University of Pennsylvania)

Abstract

Many HIV testing programs in Africa and elsewhere aim to reduce risk-taking behaviors by providing individuals with information about their own HIV status. This paper examines how beliefs about own HIV status affect risky sexual behavior using data from married couples living in three regions of Malawi. Risky behavior is measured as the propensity to engage in extramarital affairs or to not use condoms. The empirical analysis is based on two panel surveys for years 2004 and 2006 from the Malawi Diffusion and Ideational Change Project (MDICP) and from an experimental HIV testing intervention carried out in 2004 that provided randomized incentives for picking up test results. Most individuals participating in the MDICP testing learned that they were HIV negative and a small fraction that they were positive. Controlling for potential endogeneity between beliefs and risk-taking, we find that downward revisions in the subjective belief of being HIV positive lead to decreases in the propensity to engage in extra-marital affairs but have no effect on condom use. These results are generally supported by survey questions that directly elicited from respondents how participating in testing altered their behavior. We show that the estimates provide a lower bound in the presence of measurement error in extra-marital affairs.

Suggested Citation

  • Aureo de Paula & Gil Shapira & Petra Todd, 2008. "How Beliefs about HIV Status Affect Risky Behaviors: Evidence from Malawi," PIER Working Paper Archive 08-035, Penn Institute for Economic Research, Department of Economics, University of Pennsylvania.
  • Handle: RePEc:pen:papers:08-035
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    File URL: http://economics.sas.upenn.edu/system/files/working-papers/08-035.pdf
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    References listed on IDEAS

    as
    1. Oster, Emily, 2012. "HIV and sexual behavior change: Why not Africa?," Journal of Health Economics, Elsevier, vol. 31(1), pages 35-49.
    2. Tomas J. Philipson & Richard A. Posner, 1995. "A Theoretical and Empirical Investigation of the Effects of Public Health Subsidies for STD Testing," The Quarterly Journal of Economics, Oxford University Press, vol. 110(2), pages 445-474.
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    7. Mechoulan Stéphane, 2004. "HIV Testing: a Trojan Horse?," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 4(1), pages 1-26, August.
    8. FFF1Georges NNN1Reniers, 2003. "Divorce and Remarriage in Rural Malawi," Demographic Research Special Collections, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 1(6), pages 175-206, September.
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    Cited by:

    1. Delavande, Adeline & Giné, Xavier & McKenzie, David, 2011. "Measuring subjective expectations in developing countries: A critical review and new evidence," Journal of Development Economics, Elsevier, vol. 94(2), pages 151-163, March.
    2. Armand, Alex & Carneiro, Pedro & Locatelli, Andrea & Mihreteab, Selam & Keating, Joseph, 2017. "Do public health interventions crowd out private health investments? Malaria control policies in Eritrea," Labour Economics, Elsevier, vol. 45(C), pages 107-115.
    3. Wilson, Nicholas, 2016. "Antiretroviral therapy and demand for HIV testing: Evidence from Zambia," Economics & Human Biology, Elsevier, vol. 21(C), pages 221-240.
    4. 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 Graduate School of Economics.
    5. 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.
    6. 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).
    7. Corno, Lucia & De Paula, Áureo, 2014. "Risky sexual behavior: biological markers and self-reported data," CEPR Discussion Papers 10271, C.E.P.R. Discussion Papers.
    8. Ernesto Reuben & Matthew Wiswall & Basit Zafar, 2017. "Preferences and Biases in Educational Choices and Labour Market Expectations: Shrinking the Black Box of Gender," Economic Journal, Royal Economic Society, vol. 127(604), pages 2153-2186, September.
    9. Zelalem Yilma & Owen O’Donnell & Anagaw Mebratie & Getnet Alemu & Arjun S. Bedi, 2015. "Subjective Expectations of Medical Expenditures and Insurance in Rural Ethiopia," Tinbergen Institute Discussion Papers 15-120/V, Tinbergen Institute.
    10. Kim, Jinho, 2016. "The effect of peers on HIV infection expectations among Malawian adolescents: Using an instrumental variables/school fixed effect approach," Social Science & Medicine, Elsevier, vol. 152(C), pages 61-69.
    11. Adeline Delavande & Jinkook Lee & Seetha Menon, 2017. "Eliciting Survival Expectations of the Elderly in Low-Income Countries: Evidence From India," Demography, Springer;Population Association of America (PAA), vol. 54(2), pages 673-699, April.

    More about this item

    Keywords

    Beliefs; AIDS; Malawi;

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

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