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This paper examines how beliefs about own HIV status aect decisions to engage in risky sexual behavior, as measured by having extramarital sex and/or multiple sex partners. The empirical analysis is based on a panel survey of males from the 2006 and 2008 rounds of the Malawi Diusion and Ideational Change Project (MDICP). The paper first develops a behavioral model of the belief-risky behavior relationship. It then estimates the causal effect of beliefs on risky behavior in a way that takes into account the belief updating mechanisms implied by the model. In particular, the Arellano and Carrasco (2003) semiparametric panel data estimator that is used accommodates both unobserved heterogeneity and belief endogeneity, arising from dependence of current beliefs on past risky behavior. Results show that downward revisions in the belief assigned to being HIV positive increase risky behavior and upward revisions decrease it. We estimate for example that a change in the perceived probability of being HIV positive from 0 to 100% reduces risky behavior between 13.7 and 36.4 percentage points depending on the risky behavior definition and year. Implementation of a modied estimator that allows for misreporting of risky behavior finds the estimates to be downward biased but relatively robust to a wide range of plausible misreporting levels. Download Paper
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. Download Paper
This paper examines how beliefs about own HIV status affect decisions to engage in risky sexual behavior using data on married males living in 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). Beliefs vary significantly over time in the data, in part because of HIV testing and informational campaigns. We estimate the effect of beliefs about own HIV status on risky behavior 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 beliefs are an important determinant of risky behavior, with downward revisions in the belief of being HIV positive increasing risky behavior and upward revisions decreasing it. We modify Arellano and Carrasco’s (2003) estimator to allow for underreporting of affairs and find the estimates to be relatively robust to underreporting. Using our estimates and a prototypical epidemiological model of disease transmission, we show that making individuals better informed about their HIV status, either by increasing the credibility of test results and/or increasing access to testing, would on net reduce the HIV transmission rate. Download Paper
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 HV-positive person. Download Paper
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, in part 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). The estimator 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. Download Paper
This paper examines how beliefs about own HIV status affect sexual behavior. Risky behavior is measured as the propensity to engage in extramarital affairs or not use condoms. The empirical analysis is based on 2004 and 2006 data from the Malawi Diffusion and Ideational Change Project. Controlling for endogeneity between beliefs and risk-taking, we find that downward revisions in the belief of being HIV positive lead to a lower propensity to engage in extramarital affairs but have no effect on condom use. We show that the estimates provide a lower bound when there is measurement error in reported extra-marital affairs. Download Paper
Many HIV testing programs in Africa and elsewhere aim to reduce risk-taking behaviors by providing individuals with information about their own HIV status. This paper examines how beliefs about own HIV status affect risky sexual behavior using data from married couples living in three regions of Malawi. Risky behavior is measured as the propensity to engage in extramarital affairs or to not use condoms. The empirical analysis is based on two panel surveys for years 2004 and 2006 from the Malawi Diffusion and Ideational Change Project (MDICP) and from an experimental HIV testing intervention carried out in 2004 that provided randomized incentives for picking up test results. Most individuals participating in the MDICP testing learned that they were HIV negative and a small fraction that they were positive. Controlling for potential endogeneity between beliefs and risk-taking, we find that downward revisions in the subjective belief of being HIV positive lead to decreases in the propensity to engage in extra-marital affairs but have no effect on condom use. These results are generally supported by survey questions that directly elicited from respondents how participating in testing altered their behavior. We show that the estimates provide a lower bound in the presence of measurement error in extra-marital affairs. Download Paper