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Unformatted text preview: i.e., to remain uninfected—may increase after diagnosis; however, the
lack of need to protect a sexual partner may cause condom use to fall.13 Thus, how learning HIV
results affects sexual behavior is ultimately an empirical question.
Previous studies examining the effects of HIV testing on sexual behavior have not only been
inconclusive, but also suffer from selection bias in terms of which individuals chose to learn 12 For a formal model of testing see Michael Boozer and Philipson (2000).
Individuals may also update their priors, believing they have a lower likelihood of future infection, resulting in no
change, or a decrease in safe sex, after learning HIV-negative results.
13 1846 THE AMERIcAN EcONOMIc REVIEW DEcEMBER 2008 their results.14 In this study, however, the randomly assigned VCT center distances and monetary
incentives serve as exogenous instruments for knowledge of status. Nevertheless, several estimation challenges and limitations remain.
One challenge to measuring the demand for safe sex in response to HIV testing is that sexual
behavior is difficult to measure and self-reports may be unreliable. Prior research has found that
sexual behavior, such as number of sexual partners, is likely to be underreported and that contraceptive use is sometimes overreported (Landon Myer, C. Morroni, and B. G. Link 2004; Susan
Allen et al. 2003). Because of the potential bias of self-reports, the primary outcome variable used
to measure the demand for safe sex in this paper is the actual purchase of condoms from survey
interviewers. To mitigate potential reporting biases during follow-up interviews, every effort was
made to conduct interviews privately with an interviewer of the same sex as the respondent, who
had no part in the HIV testing or in giving results.
It is important to keep in mind that condom purchases may not reflect the true demand for
safe sex. If knowledge of HIV status increases abstinence, the demand for condoms could fall in
response to obtaining test results....
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