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including self-selection. VOL. 98 NO. 5 THORNTON: THE DEMAND fOR, AND IMpAcT Of, LEARNING HIV STATUS 1831 of distance on VCT attendance: living over 1.5 kilometers from the VCT center reduced attendance by 6 percent.
Several months later, follow-up interviews were conducted and respondents were given the
opportunity to purchase condoms. Using the random allocation of incentives and distance as
exogenous instruments for learning HIV status, I find that receiving an HIV-positive diagnosis
significantly increased the likelihood of purchasing condoms among those with a sexual partner.
However, the total number of condoms purchased by HIV-positive individuals who knew their
test results was small. On average, those with a sexual partner who learned they were HIVpositive purchased two more condoms than those HIV-positives who did not learn their results.
Learning HIV results had no impact on condom purchases among those who were HIV-negative
or those who were not sexually active.
This paper measures the impact of learning HIV results on sexual activity and condom purchases two months later. While there may be other prevention strategies that individuals undertake after learning their results that are not measured in this paper, the findings presented here
suggest that door-to-door testing may not be as cost-effective as other prevention programs in
averting new infections. There may be a role for HIV testing, however, if it is targeted at high-risk
groups. In addition, the findings in this paper suggest that offering small rewards to encourage
people to learn their results may be very effective, for example, in giving HIV-positive individuals access to treatment or in distributing antiretroviral therapy to pregnant women to prevent
HIV transmission to their baby.
I. Project Design A. Background on Malawi and Description of the Data
The Malawi Diffusion and Ideational Change Project (MDICP) is conducted in Malawi, a
land-locked country located in southern Africa (Figure 1). This collaborative project between the
University of Pennsylvania and the Malawi College of Medicine is an ongoing study of men and
women randomly selected from approximately 120 villages in the districts of Rumphi, Mchinji,
and Balaka, located in the Northern, Central, and Sout...
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