The Effect of HIV Infection Risk Beliefs on Risky Sexual Behavior: Scared Straight or Scared to Death?

Jason Kerwin, University of Michigan

Models of risk compensation generally assume self-protective effects – that people take fewer chances as risks increase. However, rational responses can instead be positive, or fatalistic: increased risks can lead to more risk-taking. I examine this possibility using a randomized experiment that provided information on HIV transmission to people in rural Malawi. The average risk elasticity of sexual behavior is fairly small, at roughly -0.5, but statistically significant. However, responses are strongly heterogeneous by baseline risk beliefs. I develop a novel estimation strategy that extends heterogeneous treatment effects analysis to the marginal effect of risk beliefs on sexual risk-taking. Using this approach, I find that over 10% of the population has risk beliefs high enough that they have become fatalistic: their risk elasticity of sexual behavior is positive rather than negative. They also have higher baseline indicators of sexual activity, suggesting that HIV risk messaging may be backfiring for this subpopulation.

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Presented in Session 163: HIV-AIDS and Sexually Transmitted Diseases