Direct and Spillover Impacts of a Community-Level HIV/AIDS Program: Evidence from a Randomized Controlled Trial in Mozambique EconomicsInternational DevelopmentPre-Results AcceptancesPublic Health
Dean Yang Arlete Mahumane James Riddell Hang Yu
We study a prominent effort to help families cope with HIV/AIDS: a U.S. government-funded program in Mozambique implementing an interrelated set of health and education interventions. We report the results of a randomized evaluation of this program. We hypothesize that the program raises HIV testing rates by reducing imperfect information (related to HIV) and by reducing HIV-related stigma concerns. Primary outcome variables are survey-reported and directly-observed rates of HIV testing. We also examine a range of secondary outcomes related to information and stigma mechanisms, and secondary outcome variables such as school attendance and overall household well-being. Causal identification exploits multilevel random assignment (of communities to program receipt, and of treatment-community households to strong encouragement for program participation), allowing separate identification of impacts on households of being in a program community (with take-up at the community-average rate), versus having been strongly encouraged to participate the program (with very high take-up). We also examine spillovers (based on geographic proximity or social network connections) from strongly encouraged to other households. Additional treatments randomly assigned by our research team allow insight into complementarities with interventions providing targeted information and financial incentives for HIV testing.