Center for Global Development
1800 Massachusetts Ave. NW, Third Floor
10:00-11:30 am
Rebecca Thornton, a Ph.D. candidate at Harvard University will present "The Demand for and Impact of Learning HIV Status: Evidence from a Field Experiment."
Please RSVP to Sarah Dean by Feb 21st at events@cgdev.org
Abstract: It is commonly believed that HIV testing is essential for disease prevention. Indeed, spending on counseling and testing accounts for over half of the total expenditures on HIV prevention in some African countries. Despite this, there is evidence that even when testing is available most people do not take advantage of it, and there is virtually no persuasive evidence on the behavioral response to knowing one's status. For this paper, I designed and implemented a randomized experiment to evaluate the demand for learning HIV results and to estimate subsequent behavior change. In the experiment, over 2,700 individuals in rural Malawi were randomly assigned monetary incentives to learn their HIV results after testing. Two months later, they were re-interviewed and given the opportunity to purchase condoms. I find that while less than half of the participants attended clinics to learn their HIV status without any incentive, even a very small incentive (about one-tenth of a day’s wage) increased the share learning their results by 50%. Using the exogenously assigned incentives and distance from results centers as instruments for HIV knowledge, I find that HIV positive subjects with a sexual partner who learn their status purchase significantly more condoms; however, the average number of condoms purchased is low. Using these estimates, I calibrate an epidemiological model of infection that suggests that HIV testing is not as cost-effective as other prevention strategies; however, if testing services already exist, offering incentives may more effectively avert new infections.
