Working Paper: NBER ID: w10516
Authors: Dana Goldman; Darius Lakdawalla; Neeraj Sood
Abstract: Recent breakthroughs in the treatment of HIV have coincided with an increase in infection rates and an eventual slowing of reductions in HIV mortality. These trends may be causally related, if treatment improves the health and functional status of HIV+ individuals and allows them to engage in more sexual risk-taking. We examine this hypothesis empirically using access to health insurance as an instrument for treatment status. We find that treatment results in more sexual risk-taking by HIV+ adults, and possibly more of other risky behaviors like drug abuse. This relationship implies that breakthroughs in treating an incurable disease like HIV can increase precautionary behavior by the uninfected and thus reduce welfare. We also show that, in the presence of this effect, treatment and prevention are social complements for incurable diseases, even though they are substitutes for curable ones. Finally, there is less under-provision of treatment for an incurable disease than a curable one, because of the negative externalities associated with treating an incurable disease.
Keywords: HIV; HAART; sexual behavior; public health; treatment
JEL Codes: I1
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| HAART (Q16) | sexual risk-taking behavior (D91) |
| HAART (Q16) | health and functional status (I14) |
| health and functional status (I14) | sexual risk-taking behavior (D91) |
| HAART (Q16) | risk of infection for the uninfected (I12) |
| HAART (Q16) | need for preventive measures (I32) |
| HAART and prevention (Q16) | public health challenges (I14) |