Assignment #5 - 20.04.15 1 Pisani claims that her own...

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20.04.15 1. Pisani claims that her own statement, “People do stupid things – that’s what spreads HIV” is only half true. It is true that people do stupid things, and are at higher risk for getting HIV because of these actions. That is not under debate. The issue is that people do these stupid things and put themselves at risk for rational reasons, or what they believe are rational reasons. If people are not made aware of the risks, of what is good or bad for them, and worse, are not privy to the services to help them make these decisions, then they will continue doing stupid things. Pisani brings up how rationality also varies on the person’s situation. For example, as she says, a drug addict in jail will accept a needle after 21 other people have used it, because in his rational, it makes more sense to take the risk of a dirty needle than pass up a high. In a similar situation, a drug addict in Indonesia will share a needle because if he or she is caught with a clean needle, they will be put in jail. In their rational, it is more logical to take the risk of getting HIV than go to jail for a year for trying to stay safe. It is not rational to those of us who are not drug addicts, but when it is safety or a high, they will choose the high any time. We need to change policies to make people do stupid things less times. 2. Pisani talks about how this problem of drug addicts and clean needles is one that can be easily solved by policies. As she says, this is one of the cases where the incentives of both sides are aligned, which allows for easy policy making. Public health workers want people to use clean needles to prevent the spread of HIV, and drug addicts want to use clean needles to protect themselves. So then, it makes sense to create policies allowing this to happen. This is where her graph comes in. It depicts the HIV prevalence among drug users in three countries who have taken advantage of this incentive alignment and
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created a needle exchange program. The first to do this was the UK, then Australia and the Netherlands, each with less than 4 percent prevalence. The remaining information on the graph depicts three places that have not taken advantage of this information, New York, Jakarta, and Moscow, and therefore maintain around 50 percent prevalence.
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