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Unformatted text preview: the study (Table 1, panel C).
II. Learning HIV Results A. Theoretical considerations
To the extent that individuals use the knowledge of their HIV test results to alter their behavior,
there could be positive effects from HIV testing on sexual behavior. Those diagnosed negative
can practice safe sex to protect themselves from future infection; those diagnosed positive can
seek treatment, and if altruistic, can prevent spreading the virus to children or sexual partners.
Furthermore, knowing HIV status may allow individuals to more realistically and effectively
plan for the future. However, while people with treatable diseases have strong motivations for
testing and diagnosis, these incentives may be absent for people concerned about HIV because
it is incurable. Also, in low-income countries access to antiretroviral therapies that would slow
disease progress is often limited, further reducing the incentive to learn HIV results (Peter Glick
2005; Jo Stein 2005). Moreover, even when antiretroviral therapies are available, most patients
must wait until they have severe symptoms before receiving treatment. The costs of testing and
travel may also prevent individuals from learning their HIV status (Steven Forsythe et al. 2002;
Laver 2001; Areleen A. Leibowitz and Stephanie L. Taylor 2007; M. Isabel Fernandez et al.
2005) although testing rates are usually low even when testing services are free or low-cost. For
example, although HIV testing is free in Malawi, only 14 percent of respondents reported ever
having been tested (Malawi DHS 2004). Even when individuals choose to be tested for HIV,
many do not return for their results: in meta-studies of clinics across Africa, only approximately
65 percent of individuals who tested for HIV returned to learn their results (Michel Cartoux et
al. 1998; Donatus Ekwueme et al. 2003).7
It is therefore commonly suggested that psychological costs are important, perhaps crucial,
barriers to testing and learning results. The psychological costs associated with learning HIV
results can be either internal, such as having worry or fear, or external, such as experiencing...
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