Description:
This paper studies the effect of
increased access to antiretroviral therapy on risky sexual
behavior, using data collected in Mozambique in 2007 and
2008. The survey sampled both households of randomly
selected HIV positive individuals and households from the
general population. Controlling for unobserved individual
characteristics, the findings support the hypothesis of
disinhibition behaviors, whereby risky sexual behaviors
increase in response to the perceived changes in risk
associated with increased access to antiretroviral therapy.
Furthermore, men and women respond differently to the
perceived changes in risk. In particular, risky behaviors
increase for men who believe, wrongly, that AIDS can be
cured, while risky behaviors increase for women who believe,
correctly, that antiretroviral therapy can treat AIDS but
cannot cure it. The findings suggest that scaling up access
to antiretroviral therapy without prevention programs may
not be optimal if the objective is to contain the disease,
since people would adjust their sexual behavior in response
to the perceived changes in risk. Therefore, prevention
programs need to include educational messages about
antiretroviral therapy, and address the changing beliefs
about HIV in the era of increasing antiretroviral therapy availability.