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Unformatted text preview: any have suggested that psychological barriers, such as fear or stigma, play an important role
in deterring individuals from testing (or seeking test results). I find, however, that these barriers,
if they exist at all, can be easily overcome by offering small cash rewards. Incentives may compensate individuals directly for their cost of obtaining results or serve as a public justification
for attending a results center, indirectly reducing psychological costs. One woman’s remark,
overheard by an interviewer, is especially illustrative:
Those who were lucky were picking [vouchers] with some figures and those were courageous to go and check their blood test results because they were also receiving their money
there so like me where I got a zero. I did not even go and check the results because I knew
that there was nothing for me there (Malawi Diffusion Ideational Change Project 2004).
These findings reemphasize the importance of economic costs such as travel or opportunity
costs in decision making and the effects of monetary incentives to overcome these costs.
III. Impact of Learning HIV Status A. Theoretical and Measurement considerations
In a standard expected utility framework, individuals do not receive any additional utility
from learning their HIV status. Testing is beneficial only to the extent that it provides new information that can be used for updating behavior.12 However, it is theoretically ambiguous how the
knowledge of HIV status affects sexual behavior and, in particular, the demand for condoms.
For those diagnosed HIV-positive, the direct benefits of using condoms fall because (if safe sex
is costly) there is no longer any need of protection. However, HIV-positive individuals who are
sufficiently altruistic may exhibit a higher demand for condoms after learning their status. On the
other hand, if infected individuals behave selfishly, there may be a decrease in the demand for
condoms (Stephane Mechoulan 2004). For HIV-negatives, it is similarly ambiguous: the benefit
from using condoms...
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