title: Do Customers Flee From HIV? A Survey of HIV Stigma and Its Potential Economic Consequences on Small Businesses in Tshwane (Pretoria), South Africa.
abstract: HIV stigma and discrimination affect care-seeking behavior and may also affect entrepreneurial activity. We interview 2382 individuals in Pretoria, South Africa, and show that respondents believe that businesses with known HIV+ workers may lose up to half of their customers, although the impact depends on the type of business. Survey respondents' fear of getting HIV from consuming everyday products sold by the business-despite a real infection risk of zero-was a major factor driving perceived decline in customers, especially among food businesses. Respondents' perceptions of the decline in overall life satisfaction when one gets sick from HIV and the respondent's dislike of people with HIV were also important predictors of potential customer exit. We suggest policy mechanisms that could improve the earnings potential of HIV+ workers: reducing public health scare tactics that exacerbate irrational fear of HIV infection risk and enriching public health education about HIV and ARVs to improve perceptions about people with HIV.
authors.affiliation: Population Studies Center, University of Pennsylvania, Philadelphia, USA.|Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, USA.|Porto Business School, University of Porto, Porto, Portugal.|HIV/AIDS, STIs and TB Research Programme, Human Sciences Research Council, Pretoria, South Africa.|Centre for Economics and Finance, University of Porto, Rua Roberto Frias, 4200-464, Porto, Portugal.
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Chao
authors.affiliation: Porto Business School, University of Porto, Porto, Portugal. hszrek@wharton.upenn.edu.|Centre for Economics and Finance, University of Porto, Rua Roberto Frias, 4200-464, Porto, Portugal. hszrek@wharton.upenn.edu.
authors.forename: Helena
authors.identifier: http://orcid.org/0000-0002-5154-4679
authors.initials: H
authors.lastname: Szrek
authors.affiliation: Centre for Economics and Finance, University of Porto, Rua Roberto Frias, 4200-464, Porto, Portugal.|Faculty of Economics, University of Porto, Porto, Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: Leite
authors.affiliation: HIV/AIDS, STIs and TB Research Programme, Human Sciences Research Council, Pretoria, South Africa.
authors.forename: Shandir
authors.initials: S
authors.lastname: Ramlagan
authors.affiliation: HIV/AIDS, STIs and TB Research Programme, Human Sciences Research Council, Pretoria, South Africa.|Department of Research Innovation and Development, University of Limpopo, Polokwane, South Africa.|ASEAN Institute for Health Development, Mahidol University, Bangkok, Thailand.
authors.forename: Karl
authors.initials: K
authors.lastname: Peltzer
mesh_terms: D000328:Adult; D005239:Fear; D005260:Female; D015658:HIV Infections; D015438:Health Behavior; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D058012:Small Business; D057545:Social Stigma; D013019:South Africa; D011795:Surveys and Questionnaires
keywords: Consequences of stigma; HIV stigma; Infection risk; Quality of life; Small businesses