Risk Compensation and HIV Therapy: A Field Experiment in South Africa

Risk compensation—the phenomenon positing that people adjust their risky behaviours in response to changes in perceived risks—could have the adverse effect of worsening health outcomes. Consequently, understanding potential behavioural responses is critical for designing effective public policies. This study examines the relationship between improved human immunodeficiency virus (HIV) therapy and subsequent risky sexual behaviour. Using a field experiment in South Africa, I estimate the causal effects of improved HIV therapy adherence on subsequent risky sexual behaviour among HIV-positive patients. I find that access to HIV therapy induces a substantial increase in the demand for unsafe sex.

风险补偿（risk compensation）是指人们会根据感知到的风险变化调整自身风险行为的现象，该现象可能引发健康结局恶化的负面影响。因此，厘清潜在的行为反应对于制定高效的公共政策至关重要。本研究探讨了人类免疫缺陷病毒（HIV）治疗手段优化与后续危险性行为之间的关联。通过在南非开展的实地实验，本研究估算了提升HIV治疗依从性对HIV阳性患者后续危险性行为的因果效应。研究发现，获取HIV治疗会显著提升患者对不安全性行为的需求。