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The heterogeneous effects of HIV testing

  • Baird, Sarah
  • Gong, Erick
  • McIntosh, Craig
  • Ozler, Berk

An extensive multi-disciplinary literature examines the effects of learning one's HIV status on subsequent risky sexual behaviors. However, many of these studies rely on non-experimental designs; use self-reported outcome measures, or both. This study investigates the effects of a randomly assigned home based HIV testing and counseling (HTC) intervention on risky sexual behaviors and schooling investments among school-age females in Malawi. The study finds no overall effects on HIV, Herpes Simplex Virus (HSV-2), or achievement test scores at follow-up. However, among the small group of individuals who tested positive for HIV, a large increase in the probability of contracting HSV-2 is found, with this effect stronger among those surprised by their test results. Similarly, those surprised by HIV-negative test results see a significant improvement in achievement test scores, consistent with increased returns to investments in human capital. The finding of increased HSV-2 prevalence among HIV-positive individuals suggests that the conventional wisdom that those who learn they are HIV-positive will adopt safer sexual practices should be treated with caution.

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Paper provided by The World Bank in its series Policy Research Working Paper Series with number 6823.

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Date of creation: 01 Mar 2014
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Handle: RePEc:wbk:wbrwps:6823
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  1. Emily Oster & Ira Shoulson & E. Ray Dorsey, 2011. "Optimal Expectations and Limited Medical Testing: Evidence from Huntington Disease," NBER Working Papers 17629, National Bureau of Economic Research, Inc.
  2. David S. Lee, 2009. "Training, Wages, and Sample Selection: Estimating Sharp Bounds on Treatment Effects," Review of Economic Studies, Oxford University Press, vol. 76(3), pages 1071-1102.
  3. Markus Goldstein & Joshua Graff Zivin & James Habyarimana & Cristian Pop-Eleches & Harsha Thirumurthy, 2013. "The Effect of Absenteeism and Clinic Protocol on Health Outcomes: The Case of Mother-to-Child Transmission of HIV in Kenya," American Economic Journal: Applied Economics, American Economic Association, vol. 5(2), pages 58-85, April.
  4. Áureo de Paula & Gil Shapira & Petra E. Todd, 2011. "How Beliefs about HIV Status Affect Risky Behaviors: Evidence from Malawi, Seventh Version," PIER Working Paper Archive 11-033, Penn Institute for Economic Research, Department of Economics, University of Pennsylvania, revised 15 Oct 2011.
  5. Robert Jensen, 2010. "The (Perceived) Returns to Education and the Demand for Schooling," The Quarterly Journal of Economics, MIT Press, vol. 125(2), pages 515-548, May.
  6. Michael A. Boozer & Tomas J. Philipson, 2000. "The Impact of Public Testing for Human Immunodeficiency Virus," Journal of Human Resources, University of Wisconsin Press, vol. 35(3), pages 419-446.
  7. Sarah Baird & Craig McIntosh & Berk �zler, 2011. "Cash or Condition? Evidence from a Cash Transfer Experiment," The Quarterly Journal of Economics, Oxford University Press, vol. 126(4), pages 1709-1753.
  8. Michael Kremer, 1996. "Integrating Behavioral Choice into Epidemiological Models of the AIDS Epidemic," NBER Working Papers 5428, National Bureau of Economic Research, Inc.
  9. Kremer, Michael, 1996. "Integrating Behavioral Choice into Epidemiological Models of AIDS," The Quarterly Journal of Economics, MIT Press, vol. 111(2), pages 549-73, May.
  10. Anderson, Michael L., 2008. "Multiple Inference and Gender Differences in the Effects of Early Intervention: A Reevaluation of the Abecedarian, Perry Preschool, and Early Training Projects," Journal of the American Statistical Association, American Statistical Association, vol. 103(484), pages 1481-1495.
  11. Baird, Sarah & Özler, Berk, 2012. "Examining the reliability of self-reported data on school participation," Journal of Development Economics, Elsevier, vol. 98(1), pages 89-93.
  12. Aureo de Paula & Gil Shapira & Petra E. Todd, 2008. "How Beliefs about HIV Status Affect Risky Behaviors: Evidence from Malawi, Fifth Version," PIER Working Paper Archive 10-023, Penn Institute for Economic Research, Department of Economics, University of Pennsylvania, revised 10 Jul 2010.
  13. Poulin, Michelle, 2007. "Sex, money, and premarital partnerships in southern Malawi," Social Science & Medicine, Elsevier, vol. 65(11), pages 2383-2393, December.
  14. Thornton, Rebecca L., 2012. "HIV testing, subjective beliefs and economic behavior," Journal of Development Economics, Elsevier, vol. 99(2), pages 300-313.
  15. Rebecca L. Thornton, 2008. "The Demand for, and Impact of, Learning HIV Status," American Economic Review, American Economic Association, vol. 98(5), pages 1829-63, December.
  16. Adeline Delavande & Hans-Peter Kohler, 2012. "The Impact of HIV Testing on Subjective Expectations and Risky Behavior in Malawi," Demography, Springer, vol. 49(3), pages 1011-1036, August.
  17. Erick Gong, 2011. "HIV Testing and Risky Sexual Behavior," Middlebury College Working Paper Series 1101, Middlebury College, Department of Economics.
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