RAND Corporation, Santa Monica, CA 90407, USA.
Demography. 2012 Aug;49(3):1011-36. doi: 10.1007/s13524-012-0119-7.
We investigate the causal impact of learning HIV status on HIV/AIDS-related expectations and sexual behavior in the medium run. Our analyses document several unexpected results about the effect of learning one's own, or one's spouse's, HIV status. For example, receiving an HIV-negative test result implies higher subjective expectations about being HIV-positive after two years, and individuals tend to have larger prediction errors about their HIV status after learning their HIV status. If individuals in HIV-negative couples also learn the status of their spouse, these effects disappear. In terms of behavioral outcomes, our analyses document that HIV-positive individuals who learned their status reported having fewer partners and using condoms more often than those who did not learn their status. Among married respondents in HIV-negative couples, learning only one's own status increases risky behavior, while learning both statuses decreases risky behavior. In addition, individuals in sero-discordant couples who learned both statuses are more likely to report some condom use. Overall, our analyses suggest that ensuring that each spouse learns the HIV status of the other, either through couple's testing or through spousal communication, may be beneficial in high-prevalence environments.
我们研究了在中期内了解 HIV 状况对与 HIV/AIDS 相关的期望和性行为的因果影响。我们的分析记录了关于了解自己或配偶 HIV 状况的影响的一些意外结果。例如,接受 HIV 阴性测试结果意味着两年后对 HIV 阳性的主观期望更高,并且个体在了解自己的 HIV 状况后往往对自己的 HIV 状况存在更大的预测误差。如果 HIV 阴性夫妇中的个体也了解其配偶的状况,则这些影响会消失。在行为结果方面,我们的分析表明,了解自己状况的 HIV 阳性个体报告的性伴侣较少,使用避孕套的频率也高于那些不了解自己状况的个体。在 HIV 阴性夫妇中的已婚受访者中,仅了解自己的状况会增加风险行为,而了解双方的状况则会降低风险行为。此外,了解双方状况的血清不一致的夫妇更有可能报告使用一些避孕套。总体而言,我们的分析表明,在高流行环境中,确保配偶双方通过夫妻检测或配偶间沟通了解对方的 HIV 状况可能是有益的。