Antiretroviral Therapy Perceived Efficacy and Risky Sexual Behaviors

Evidence from Mozambique

Bibliographic Data

ID3200840
AuthorsDamien De Walque (0000-0003-1592-7602, corresponding author), Harounan Kazianga (0000-0001-6780-9945, Oklahoma State University Oklahoma City, corresponding author), Mead Over (0000-0003-4311-2080, Center for Global Development, corresponding author)
Year2012
Volume61
Issue1
Pages97-126
Publication date2012-10-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueEconomic Development and Cultural Change (JOURNAL)
Journal identifiersISSN: 0013-0079 • E-ISSN: 1539-2988
PublisherUniversity of Chicago Press (PUBLISHER • US)
DOI10.1086/666951
OpenAlexW1964969369
LanguageEN
Citations received4
References cited26

This paper studies the effect of increased access to antiretroviral therapy (ART) for AIDS on self-reported risky sexual behavior, using data collected in Mozambique in 2007 and 2008. The survey sampled both households from randomly selected HIV positive individuals and comparison households from the general population. Controlling for unobserved individual characteristics, our findings support the hypothesis of disinhibition behaviors, in which people report more sexual risk taking when they perceive ART as more efficacious. In particular, risky behaviors are more positively associated with efficacious ART for family members of HIV positive persons and for individuals from comparison households. However, over the study period, we find that increased experience with ART at the nearest health facility has decreased, rather than increased, the perceived efficacy of ART. To the degree that the perceived efficacy of ART has declined, perhaps because people have known more patients who have failed treatment, people’s sexual behavior has become more cautious. Our findings suggest that risk behavior is sensitive to the perceived efficacy of ART programs and that efforts to expand ART access or reduce ART failure rates must be supplemented with programs to prevent a resurgence of risky sexual behavior. We stress that our identification strategy reveals associations, and therefore our findings should not be interpreted as causal

Antiretroviral therapy · Environmental health · Family medicine · Human immunodeficiency virus (HIV) · Population · Risky sexual behavior · Sexual behavior · Sexually active · Viral load · Adolescent Sexual and Reproductive Health · Clinical Psychology · Demography · HIV/AIDS Research and Interventions · Medicine · Psychology · Sex work and related issues