Suppression and Deterrence: Revisiting the Welfare Consequence of HIV Stigma

TL;DR

This paper explores how HIV stigma simultaneously suppresses testing and deters risky behaviors, revealing that reducing stigma may not always improve societal welfare and sometimes maintaining some stigma is beneficial.

Contribution

It introduces a model that incorporates both suppression and deterrence effects of HIV stigma, showing their coexistence and impact on welfare analysis.

Findings

Net societal impact of HIV stigma is ambiguous.

Welfare-maximizing stigma level can be higher than natural.

Reducing stigma is not always welfare-improving.

Abstract

The government's effort to alleviate HIV stigma has been justified by the suppression effect of stigma on the HIV testing rate. Nevertheless, the deterrence effect of stigma on undesirable sexual behaviours has long been overlooked. This study adapts the existing framework on HIV stigma with an additional stage that formally models people's choices on whether to take preventive measures in sex. The model shows that, when sex is explicitly modelled, the suppression and deterrence effects coexist, which makes the net societal impact of HIV stigma ambiguous. A utilitarian welfare analysis concludes that the welfare-maximizing stigma level can be higher than its natural level, implying that the government's effort to reduce stigma is not always welfare-improving. Instead, the study provides a rationale for maintaining a certain level of HIV stigma to maximize social welfare.