HIV/AIDS Flashcards
how has HIV/AIDS affected economic development in Africa?
labour productivity/turnover
- disruption of labour supply
- sickness leads to absenteeism, death leads to reduction in labour force
human capital accumulation
- affects the next generation as schooling could be disrupted
- long-run effect on human capital
health costs of treating HIV/AIDS
- spending on treatment which leaves less money on investments and other things
model for HIV/AIDS spread
individual makes a decision about whether or not to engage in unsafe sex in youth
- choice is dichotomous in the model but more continuous in reality
rational decision rule where you engage in unsafe sex if the expected utility of unsafe sex is greater than that of safe sex
extension to HIV/AIDS model: thinking you’re infected or not
if you think you’re infected, no survival benefit to safe sex but you get utility from unsafe sex
- nothing to lose effect where there’s less to love and less to live for
- cost of unsafe sex is smaller than it was before
irony of early public health messaging (that stresses how widespread the HIV virus already is) is that it leads to unintended reverse consequences
- model predicts that unsafe sex should increase due to these health policy changes
extension to HIV/AIDS model: altruism
people are altruistic - don’t care about their own infection but also about infecting other people
in the model, we do this by allowing the benefits of unsafe sex to be decreasing in R
- don’t like unsafe sex nearly as much if you think you’re infected because you’ll be infecting other people
- potential to offset the nothing to lose effect
altruism effect and nothing to lose cancel out completely in this specific case
what does this simple model miss?
not all sexual choices are voluntary
social/cultural norms regarding acceptable sexual behaviour, especially regarding safe sex
paying people to avoid STIs (de Walque et. al, 2012)
are conditional cash transfers to those who remain STI negative incentive enough to avoid unsafe sex?
unsafe sex becomes less attractive if people get this incentive to stay negative
however, an extension is that different people respond differently to a given incentive
works if the incentive is sufficiently large, but also doesn’t capture all the aspects of the decision of risky sexual behaviour
testing people and informing them of their HIV status (Gong, 2015)
testing changes R to 0 or 1 depending on status
- can theoretically increase or decrease unsafe sex, depending on people’s expectations on their infection status
finding is that nothing to lose effect is dominant
- if you think you’re HIV+ but find out you’re not, likely to reduce sexual encounter, etc.
- more information doesn’t always reduce risky choices
public policies for HIV/AIDS
cash incentives to avoid STIs
increased information on HIV status
condom distribution
public health information campaigns
regulation of commercial sex work
subsidising treatment for ART
development of an HIV vaccine
reducing transmission through circumcision
HIV/AIDS in Africa
3.6% of the population infected
infection rates highest in SSA because HIV originated and spread there
- twice as many deaths in eastern/southern Africa but double the infections
of 38M infections globally, estimated that 25M are in SSA
infections and deaths falling gradually in Africa with rapid expansion of ART starting in 2003
patterns
women more at risk than men so higher infection rate
- but later in life, men’s infections continue to rise while women’s don’t
falling prevalence (in Kenya)
- 5.7% in 2010 and 4.2% in 2020
infection rates higher among wealthier households, more educated individuals, and urban households
