title: Behavioral Economics Matters for HIV Research: The Impact of Behavioral Biases on Adherence to Antiretrovirals (ARVs).
abstract: Behavioral economics (BE) has been used to study a number of health behaviors such as smoking and drug use, but there is little knowledge of how these insights relate to HIV prevention and care. We present novel evidence on the prevalence of the common behavioral decision-making errors of present-bias, overoptimism, and information salience among 155 Ugandan HIV patients, and analyze their association with subsequent medication adherence. 36 % of study participants are classified as present-biased, 21 % as overoptimistic, and 34 % as having salient HIV information. Patients displaying present-bias were 13 % points (p = 0.006) less likely to have adherence rates above 90 %, overoptimistic clients were 9 % points (p = 0.04) less likely, and those not having salient HIV information were 17 % points (p < 0.001) less likely. These findings indicate that BE may be used to screen for future adherence problems and to better design and target interventions addressing these behavioral biases and the associated suboptimal adherence.
authors.affiliation: RAND Corp, 1776 Main Street, Santa Monica, CA, 90401-3208, USA. sebastian_linnemayr@rand.org.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Linnemayr
authors.affiliation: Economics Department, UCLA, Los Angeles, CA, USA.
authors.forename: Chad
authors.initials: C
authors.lastname: Stecher
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D035843:Biomedical Research; D002755:Choice Behavior; D003657:Decision Making; D060909:Economics, Behavioral; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D015438:Health Behavior; D006801:Humans; D008297:Male; D055118:Medication Adherence; D014454:Uganda
chemical_list: D044966:Anti-Retroviral Agents
keywords: Antiretroviral therapy; Behavioral economics; Developing countries; HIV; Medication adherence; Uganda