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

Author

Listed:
  • Aureo de Paula

    () (Department of Economics, University of Pennsylvania)

  • Gil Shapira

    () (Department of Economics, University of Pennsylvania)

  • Petra E. Todd

    () (Department of Economics, University of Pennsylvania)

Abstract

This paper examines whether and to what extent changes in beliefs about own HIV status induce changes in risky sexual behavior using data from married males living in three regions of Malawi. Risky behavior is measured as the propensity to engage in extramarital affairs. The empirical analysis is based on panel surveys for years 2006 and 2008 from the Malawi Diffusion and Ideational Change Project (MDICP), which contain detailed information on beliefs about HIV status and on sexual behaviors. Many individuals change their beliefs over time, because of opportunities to get tested for HIV and informational campaigns. We estimate the effect of belief revisions on the propensity to engage in extra-marital affairs using a panel data estimator developed by Arellano and Carrasco (2003), which accommodates unobserved heterogeneity as well as belief endogeneity arising from the dependence of current beliefs on lagged behaviors. We find that downward revisions in the belief of being HIV positive lead to an increased propensity to engage in extra-marital affairs and upward revisions to a decreased propensity. The estimates are shown to be robust to underreporting of affairs. Using our estimates and a standard epidemeological model of disease transmission, we find that increasing the responsiveness of beliefs to test results would reduce the HIV transmission rate as infected individuals reduce sexual behavior and decrease the likelihood that uninfected persons have contact with an HIV-positive person.

Suggested Citation

  • Aureo de Paula & Gil Shapira & Petra E. Todd, 2009. "How Beliefs about HIV Status Affect Risky Behaviors: Evidence from Malawi, Second Version," PIER Working Paper Archive 10-004, Penn Institute for Economic Research, Department of Economics, University of Pennsylvania, revised 27 Jan 2010.
  • Handle: RePEc:pen:papers:10-004
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    References listed on IDEAS

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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. repec:bla:econom:v:86:y:2019:i:342:p:229-261 is not listed on IDEAS
    3. 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.
    4. 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.
    5. 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.
    6. Wilson, Nicholas, 2016. "Antiretroviral therapy and demand for HIV testing: Evidence from Zambia," Economics & Human Biology, Elsevier, vol. 21(C), pages 221-240.
    7. Baird, Sarah & Gong, Erick & McIntosh, Craig & Özler, Berk, 2014. "The heterogeneous effects of HIV testing," Journal of Health Economics, Elsevier, vol. 37(C), pages 98-112.
    8. 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.
    9. 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.
    10. Rachel Cassidy & Marije Groot Bruinderink & Wendy Janssens & Karlijn Morsink, 2018. "The Power to Protect: Household Bargaining and Female Condom Use," CSAE Working Paper Series 2018-08, Centre for the Study of African Economies, University of Oxford.
    11. Ruben Castro & Jere Behrman & Hans-Peter Kohler, 2015. "Perception of HIV risk and the quantity and quality of children: the case of rural Malawi," Journal of Population Economics, Springer;European Society for Population Economics, vol. 28(1), pages 113-132, January.
    12. Lucia Corno & Áureo de Paula, 2019. "Risky Sexual Behaviours: Biological Markers and Self‐reported Data," Economica, London School of Economics and Political Science, vol. 86(342), pages 229-261, April.
    13. repec:eee:deveco:v:135:y:2018:i:c:p:392-411 is not listed on IDEAS
    14. 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.
    15. 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.
    16. Thornton, Rebecca L., 2012. "HIV testing, subjective beliefs and economic behavior," Journal of Development Economics, Elsevier, vol. 99(2), pages 300-313.
    17. 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.
    18. Joachim Winter & Amelie Wuppermann, 2014. "Do They Know What Is At Risk? Health Risk Perception Among The Obese," Health Economics, John Wiley & Sons, Ltd., vol. 23(5), pages 564-585, May.
    19. Olivier STERCK, 2011. "Why only one individual tests for HIV/AIDS among Sub-Saharan African Couples?," Discussion Papers (IRES - Institut de Recherches Economiques et Sociales) 2011024, Université catholique de Louvain, Institut de Recherches Economiques et Sociales (IRES).
    20. repec:eee:ehbiol:v:30:y:2018:i:c:p:119-129 is not listed on IDEAS
    21. 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.

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    Keywords

    AIDS; Malawi; Beliefs;

    JEL classification:

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

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