Fedor Theresa M, Kohler Hans-Peter, Behrman Jere R
University of Pennsylvania, 3718 Locust Walk, 266 McNeil Building, Philadelphia, PA, 19104-6298, USA,
Demography. 2015 Feb;52(1):259-80. doi: 10.1007/s13524-014-0364-z.
This article assesses how married individuals' knowledge of HIV status gained through HIV testing and counseling (HTC) affects divorce, the number of sexual partners, and the use of condoms within marriage. This study improves upon previous studies on this topic because the randomized incentives affecting the propensity to be tested for HIV permit control for selective testing. Instrumental variable probit and linear models are estimated, using a randomized experiment administered as part of the Malawi Longitudinal Study of Families and Health (MLSFH). The results indicate that knowledge of HIV status (1) does not affect chances of divorce for either HIV-negative or HIV-positive respondents; (2) reduces the number of reported sexual partners among HIV-positive respondents; and (3) increases reported condom use with spouses for both HIV-negative and HIV-positive respondents. These results imply that individuals actively respond to information about their HIV status that they learn during HTC, invoking protective behavior against future risk of HIV/AIDS for themselves and their actual and potential sexual partners. Some limitations of this study are a small sample size for those who are HIV-positive and dependence on self-reported sexual behaviors.
本文评估了已婚人士通过艾滋病毒检测与咨询（HTC）获得的艾滋病毒感染状况知识如何影响离婚、性伴侣数量以及婚内避孕套的使用情况。本研究改进了此前关于该主题的研究，因为影响艾滋病毒检测倾向的随机激励措施能够对选择性检测进行控制。利用作为马拉维家庭与健康纵向研究（MLSFH）一部分进行的随机试验，估计了工具变量概率模型和线性模型。结果表明，艾滋病毒感染状况知识（1）对艾滋病毒检测呈阴性或阳性的受访者的离婚几率均无影响；（2）减少了艾滋病毒检测呈阳性的受访者报告的性伴侣数量；（3）增加了艾滋病毒检测呈阴性和阳性的受访者报告的与配偶使用避孕套的情况。这些结果表明，个体对他们在艾滋病毒检测与咨询期间了解到的自身艾滋病毒感染状况信息会积极做出反应，为自己以及其实际和潜在的性伴侣采取预防艾滋病毒/艾滋病未来风险的保护行为。本研究的一些局限性在于，艾滋病毒检测呈阳性者的样本量较小，且依赖自我报告的性行为。
