Research

Job Market Paper

"Social Stigma as a Barrier to HIV Testing: Evidence from a Randomized Experiment in Mozambique." [PDF] [AEA Registry]


  • Abstract: Public health experts have seen the stigma as a leading barrier affecting the delivery of HIV-related health care. By using a field experiment in Mozambique, this study identifies the role of stigma concerns in hindering HIV testing and quantifies the stigma barrier. To obtain local measures of the HIV stigma environment in the study sites, we conducted a baseline survey one year before the experiment. Experiment participants with excessive concerns, defined as overestimating the stigma in their communities, were randomly assigned an intervention to relieve stigma concerns. The intervention, which drew upon findings from the baseline survey, was designed to reveal the correct degree of stigma that a participant had overestimated. Analyses show that this intervention raised the HIV test uptake rate by 7.7 percentage points (or by 37 percent) from 20.7 percent under the control condition. To quantify the intervention effect, I introduced testing coupons of different values to estimate the demand curve for an HIV test. The concern-relieving intervention raised an individual’s willingness-to-pay for an HIV test by $1.30, or more than half of the daily cost-of-living in the study population.

Publication

“Direct and Spillover Impacts of a Community-Level HIV/AIDS Program: Evidence from a Randomized Controlled Trial in Mozambique,” with Dean Yang, Arlete Mahumane, and James Riddell. Accepted based on pre-results review at the Journal of Development Economics, July 22, 2019. [PDF] [ClinicalTrials.gov Registry] [AEA Registry]

  • Abstract: 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.

Work in Progress

“Interventions to Improve Antiretroviral Therapy Adherence in Beira, Mozambique,” with Dean Yang, James Riddell, and Arlete Mahumane. [ClinicalTrials.gov Registry] [AEA Registry]

  • Abstract: Many people living with HIV in Sub Sahara Africa failed to adhere to free Anti-retroviral Therapy (ART), the medical treatment for HIV that can stop the virus from progressing and transmitting. This paper seeks to identify the barriers to treatment adherence. We recruit patients that are new on ART from a large health center in Mozambique and randomly provide interventions to assist them in overcoming the limited attention problem, information imperfection, or social stigma concerns. We track the medication possession ratio (MPR) in six months to evaluate the interventions and benchmark their effects against conditional cash transfers. Moreover, to shed light on the spillovers of the interventions, we offer coupons for the participants to refer their partners to get tested. The experiment result will inform us of behavioral patterns of the population that are economically and physically vulnerable. Effective interventions are ready to be scaled up in HIV-treatment facilities in resource-constrained environments.

"The Value of Political Connections for Firms: The Case of Outside Directors in China."[Draft available upon request]

  • Abstract: Inviting a government official to sit on the board is a commonly used strategy for firms seeking to become politically connected. This paper estimates the value of this type of political connection with a nationwide, clearly-targeted policy shock in China. In October 2013, the central government announced a new policy restricting government officials from working in firms. Firms with government-official outside directors were affected. We find that government-official outside directors do add to firm value: The stock return of affected firms is on average 8 percentage points lower than that of the control firms in the 12 months following the policy change. The variation in treatment effects across firms suggests that firms rely on this type of political connection to different degrees. Several potential working mechanisms are explored.