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Unformatted text preview: spread of the disease. In particular, it
is assumed that those diagnosed HIV-negative will protect themselves from infection and those
diagnosed HIV-positive will take precautions to protect others. Second, many believe that it is
difficult to get people to learn their HIV status, due primarily to psychological or social barriers,
thus justifying expenditures on destigmatization and advertising campaigns.
In this paper, I evaluate a field experiment in rural Malawi designed to address these assumptions. I find that barriers to obtaining HIV test results can be easily overcome by offering small
cash incentives or by reducing the distance needed to travel for the results. I also find that
while receiving an HIV-positive diagnosis has a significant effect on the subsequent purchase
of condoms, the overall magnitude of the effect is small. The results in this paper suggest
that, relative to other available prevention strategies or targeting high-risk populations, doorto-door HIV testing may not be the most effective HIV prevention strategy, as measured by
Previous studies have attempted to measure the demand for learning HIV status, as well as
the subsequent behavioral effects. Most studies have relied on self-reported behavior by asking individuals if they want to know their HIV status (e.g., John H. Day et al. 2003; Joseph de
Graft–Johnson et al. 2005; Susan M. Laver 2001; Stanley P. Yoder and Pricilla Matinga 2004)
or asking about reported sexual behavior (e.g., The Voluntary HIV-1 Counseling and Testing
Efficacy Study Group 2000; M. Kamenga et al. 1994; M. Temmerman et al. 1990; and Lance
S. Weinhardt et al. 1999). Self-selection is also a serious limitation to evaluating the effects of
learning HIV results. Most, if not all, studies use a sample of individuals who self-select into
knowing their HIV status.3
The design of this experiment avoids the usual complications of selection and reporting bias
because it randomized individual incentives to learn HIV status, randomized the location of
VCT centers where HIV results were available, measured actual post-test attendance at centers
to obtain results, and measured actual condom purchases subseque...
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