Direct and Spillover Impacts of a Community-Level HIV/AIDS Program: Evidence from a Randomized Controlled Trial in Mozambique

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.

Knowledge, stigma, and HIV testing: An analysis of a widespread HIV/AIDS program

“…The JDE refereeing process led to minor changes to our pre-specified analyses. The JDE accepted our Pre-Results Review Paper on July 22, 2019 (Yang et al, 2019). We then uploaded the JDE Pre-Results Review Paper to our AEA RCT Registry as our second (and final) PAP on July 24, 2019.…”

Forecasting the Results of Experiments: Piloting an Elicitation Strategy

“…Study 1. Yang et al (2019) are running an experiment in Mozambique examining the effects of health and education interventions targeting households with orphaned and vulnerable children on a variety of HIV outcomes. We collected forecasts of the impact of being assigned to receive home visits from a local community worker; these visits were supposed to include referrals for HIV testing, to provide information related to HIV/AIDS, and to involve discussions to reduce concerns about stigma.…”