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


  • 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)


This paper examines how beliefs about own HIV status affect decisions to engage in risky sexual behavior (as measured by extramarital affairs) and analyzes the potential for interventions that influence beliefs, such as HIV testing and informational campaigns, to reduce transmission rates. The empirical analysis is based on a panel survey of married males for years 2006 and 2008 from the Malawi Diffusion and Ideational Change Project (MDICP). In the data, beliefs about HIV status vary significantly geographically and over time, in part because of newly available testing opportunities and because of cultural differences. We estimate the effect of beliefs on risky behavior using Arellano and Carrasco’s (2003) semiparametric panel data estimator, which accommodates unobserved heterogeneity and belief endogeneity. Results show that changes in the belief of being HIV positive induce changes in risky behavior. Downward revisions in beliefs increase risky behavior and upward revisions decrease it. We modify Arellano and Carrasco’s (2003) estimator to allow for underreporting of extramarital affairs and find the estimates to be robust. Using the estimates and a prototypical epidemiological model of disease transmission, we show that better informing people about their HIV status on net reduces the population HIV transmission rate.

Suggested Citation

  • Aureo de Paula & Gil Shapira & Petra E. Todd, 2010. "How Beliefs about HIV Status Affect Risky Behaviors: Evidence from Malawi, Sixth Version," PIER Working Paper Archive 11-005, Penn Institute for Economic Research, Department of Economics, University of Pennsylvania, revised 21 Feb 2011.
  • Handle: RePEc:pen:papers:11-005

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    References listed on IDEAS

    1. Heckman, James J. & Urzúa, Sergio, 2010. "Comparing IV with structural models: What simple IV can and cannot identify," Journal of Econometrics, Elsevier, vol. 156(1), pages 27-37, May.
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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. 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.
    3. 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.
    4. 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.
    5. Thornton, Rebecca L., 2012. "HIV testing, subjective beliefs and economic behavior," Journal of Development Economics, Elsevier, vol. 99(2), pages 300-313.
    6. 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.
    7. 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).

    More about this item


    Malawi; HIV; beliefs;

    JEL classification:

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

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