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Unformatted text preview: nt to learning HIV status. The
experimental design of this study is important because factors influencing the decision to learn
HIV results are generally correlated with behavioral outcomes, potentially biasing the estimates
of the impact of learning HIV results on the demand for safe sex.
In this study, respondents in rural Malawi were offered a free door-to-door HIV test and were
given randomly assigned vouchers between zero and three dollars, redeemable upon obtaining
their results at a nearby VCT center. The demand for HIV test results among those who received
no monetary incentive was moderate, at 34 percent. However, monetary incentives were highly
effective in increasing result-seeking behavior: on average, respondents who received any cashvalue voucher were twice as likely to go to the VCT center to obtain their HIV test results as were
individuals receiving no incentive. Although the average incentive was worth about a day’s wage,
even the smallest amount, approximately one-tenth of a day’s wage, resulted in large attendance
gains. The location of each HIV results center was also randomly placed to evaluate the impact 3
One exception to this is a study that randomly phased in individuals being tested (The Voluntary HIV-1 Counseling
and Testing Efficacy Study Group 2000). Their findings, that learning HIV results substantially reduced reported risky
sexual behavior, has since been widely cited within the public health literature and used in subsequent simulations
to conclude that counseling and testing is an effective strategy for preventing new infections (M. Sweat et al. 2000).
However, that study was conducted among self-selected individuals who choose to have an HIV test at urban health
clinics and relied on reported sexual behavior as their primary measure of behavioral change. A different study conducted by Michael Boozer and Tomas Philipson (2000) found effects of learning HIV status among gay men in San
Francisco, accounting for their prior beliefs of infection; this study also suffers from many of the limitations a...
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