Empirical Analysis of HIV Prevention Behaviours and Free Provision Policies of ART and Condoms in Botswana

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K22107
• Research Category: Grant-in-Aid for Research Activity Start-up
• Allocation Type: Multi-year Fund
• Review Section: 0107:Economics, business administration, and related fields
• Research Institution: Waseda University
• Principal Investigator: Nagashima Masaru 早稲田大学, 高等研究所, 講師(任期付) (70880277)
• Project Period (FY): 2020-09-11 – 2023-03-31
• Keywords: HIV/AIDS / 抗レトロウイルス治療薬 / 感染予防 / 政策評価

Outline of Final Research Achievements

With the research grant I obtained herein, I have been supported by two excellent research assistants who were students at Waseda University, which helped successfully merge the social survey data and health facility data using geographical information and start the statistical analysis. Among all the findings during the grant period, two most important are: (1) There was a substantial geo- and time-variation in the expansion of the free anti-retrovital therapy (ART)-providing facilities across Botswana; and (2) the difference in the time trend of outcome variables (under-age pregnancies in our analysis) in the pre-expansion period turns out to be statistically insignificant between areas that later had a nearby facility starting to provide free ART and the others. These two findings suggest that a further difference-in-difference analysis of the impact of free ART expansion on risky sexual behaviours can be an appropriate analytical strategy.

Free Research Field

開発経済学

Academic Significance and Societal Importance of the Research Achievements

本研究は、治療へのアクセスを拡大することで感染症の予防行動が減少するという理論予測通りの行動変化が実際に起きたのか、データを用いて検証することを目的とし、HIV感染者率が世界の中でも極めて高いボツワナにおける無償ART提供政策の効果測定に取り組んだ。そのために、HIVの検査結果を含む社会調査データと、無償ART提供状況のデータを、地理的に結合し、差の差法による因果推論分析に取り組んだ。研究期間中に論文完成までは至らなかったが、今後解析と論文執筆を進めて、HIV/AIDSはもちろん、疾病予防において最も重要な問いの一つに関する信頼性の高いエビデンスを発表する下地が得られたことは意義深い。