title: The indirect impact of antiretroviral therapy: Mortality risk, mental health, and HIV-negative labor supply.
abstract: To reduce the burden of the HIV/AIDS epidemic, international donors recently began providing free antiretroviral therapy (ART) in parts of Sub-Saharan Africa. ART dramatically prolongs life and reduces infectiousness for people with HIV. This paper shows that ART availability increases work time for HIV-negative people without caretaker obligations, who do not directly benefit from the medicine. A difference-in-difference design compares people living near and far from ART, before and after treatment becomes available. Next we explore the possible reasons for this pattern. Although we cannot pinpoint the mechanism, we find that ART availability substantially reduces subjective mortality risk and improves mental health. These results show an undocumented economic consequence of the HIV/AIDS epidemic and an important externality of medical innovation. They also provide the first evidence of a link between the disease environment and mental health.
authors.affiliation: University of Melbourne, Australia. Electronic address: victoria.baranov@unimelb.edu.au.
authors.forename: Victoria
authors.initials: V
authors.lastname: Baranov
authors.affiliation: University of Chicago, United States. Electronic address: dmbennett@uchicago.edu.
authors.forename: Daniel
authors.initials: D
authors.lastname: Bennett
authors.affiliation: University of Pennsylvania, United States. Electronic address: hpkohler@pop.upenn.edu.
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Kohler
mesh_terms: D000328:Adult; D000383:Agriculture / Q000191:economics* / Q000706:statistics & numerical data; D023241:Antiretroviral Therapy, Highly Active / Q000191:economics* / Q000706:statistics & numerical data; D017028:Caregivers / Q000191:economics* / Q000523:psychology; D004651:Employment / Q000191:economics* / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology / Q000523:psychology; D018023:HIV Seronegativity; D006297:Health Services Accessibility / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007390:International Agencies / Q000191:economics / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008295:Malawi / Q000453:epidemiology; D008297:Male; D008603:Mental Health; D009026:Mortality / Q000639:trends; D018570:Risk Assessment; D013997:Time Factors; D000078329:Workforce
keywords: HIV/AIDS; Labor supply; Mental health; Mortality risk