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Antiretroviral Therapy and Demand for HIV Testing: Evidence from Zambia

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Abstract

This paper examines the effects of antiretroviral therapy (ART) on demand for HIV testing and of ART-induced testing on demand for risky sexual behavior. I provide a model of sexual behavior decision-making under uncertainty and estimate the structural parameters of the model using nationally representative survey data from Zambia on HIV testing decisions before and after the introduction of ART. The empirical results indicate that although the introduction of ART increased demand for HIV testing, the ART allocation process limited the prevention benefit of ART-induced testing. Simulation results show that eliminating this prevention inefficiency while holding the supply of ART constant would increase the prevention impact of ART-induced testing more than four-fold. More generally, the analysis indicates that existing studies which examine "universal" testing or quasi-experimental testing programs understate the efficacy of standard voluntary counseling and testing programs.

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  • Nicholas Wilson, 2010. "Antiretroviral Therapy and Demand for HIV Testing: Evidence from Zambia," Department of Economics Working Papers 2010-23, Department of Economics, Williams College.
    • Handle: RePEc:wil:wileco:2010-23
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    1. Áureo De Paula & Gil Shapira & Petra E. Todd, 2014. "How Beliefs About Hiv Status Affect Risky Behaviors: Evidence From Malawi," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 29(6), pages 944-964, September.
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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Economic booms and risky sexual behavior (Ref. Zambia)
      by UDADISI in UDADISI on 2012-10-12 02:58:00
    2. Economic Growth and the HIV/AIDS Pandemic
      by Ariel Goldring in Free Market Mojo on 2010-11-21 21:00:01

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    Cited by:

    1. Rebecca Mary Myerson & Darius Lakdawalla & Lisandro D. Colantonio & Monika Safford & David Meltzer, 2018. "Effects of Expanding Health Screening on Treatment - What Should We Expect? What Can We Learn?," NBER Working Papers 24347, National Bureau of Economic Research, Inc.
    2. 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.
    3. Patrick Aylward & Hildah Essendi & Kristen Little & Nicholas Wilson, 2020. "Demand for self‐tests: Evidence from a Becker–DeGroot–Marschak mechanism field experiment," Health Economics, John Wiley & Sons, Ltd., vol. 29(4), pages 489-507, April.
    4. Okeke, Edward N. & Adepiti, Clement A. & Ajenifuja, Kayode O., 2013. "What is the price of prevention? New evidence from a field experiment," Journal of Health Economics, Elsevier, vol. 32(1), pages 207-218.
    5. Rebecca M. Myerson & Reginald D. Tucker‐Seeley & Dana P. Goldman & Darius N. Lakdawalla, 2020. "Does Medicare Coverage Improve Cancer Detection and Mortality Outcomes?," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 39(3), pages 577-604, June.
    6. Friedman, Willa Helterline, 2018. "Antiretroviral drug access and behavior change," Journal of Development Economics, Elsevier, vol. 135(C), pages 392-411.
    7. Kotsadam, Andreas & Tolonen, Anja, 2016. "African Mining, Gender, and Local Employment," World Development, Elsevier, vol. 83(C), pages 325-339.
    8. Wilson, Nicholas, 2018. "Altruism in preventive health behavior: At-scale evidence from the HIV/AIDS pandemic," Economics & Human Biology, Elsevier, vol. 30(C), pages 119-129.
    9. Tirivayi, Nyasha & Groot, Wim, 2018. "Does integrating AIDS treatment with food assistance affect labor supply? Evidence from Zambia," Economics & Human Biology, Elsevier, vol. 28(C), pages 79-91.
    10. Aureo de Paula & Gil Shapira & Petra E. Todd, 2008. "How Beliefs about HIV Status Affect Risky Behaviors: Evidence from Malawi1, Second Version," PIER Working Paper Archive 09-031, Penn Institute for Economic Research, Department of Economics, University of Pennsylvania, revised 01 Aug 2009.
    11. Eric N Ouattara & Rachel L MacLean & Christine Danel & Ethan D Borre & Delphine Gabillard & Mingshu Huang & Raoul Moh & A David Paltiel & Serge P Eholié & Rochelle P Walensky & Xavier Anglaret & Kenne, 2019. "Cost-effectiveness and budget impact of immediate antiretroviral therapy initiation for treatment of HIV infection in Côte d’Ivoire: A model-based analysis," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-16, June.
    12. Rebecca Myerson & Darius Lakdawalla & Lisandro D. Colantonio & Monika Safford & David Meltzer, 2018. "Effects of expanding health screening on treatment – What should we expect? What can we learn?," Working Papers 2018-014, Human Capital and Economic Opportunity Working Group.
    13. Wilson, Nicholas, 2015. "Child mortality risk and fertility: Evidence from prevention of mother-to-child transmission of HIV," Journal of Development Economics, Elsevier, vol. 116(C), pages 74-88.

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    More about this item

    Keywords

    HIV/AIDS; Beliefs; Selection; Rationing; Zambia;
    All these keywords.

    JEL classification:

    • D45 - Microeconomics - - Market Structure, Pricing, and Design - - - Rationing; Licensing
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • O12 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Microeconomic Analyses of Economic Development

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