HIV Treatment as Economic Stimulus: Community Spillover Effects of Mass ART Provision in Rural South Africa

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Date and Time: 
Monday, November 27, 2017
2:00 pm – 3:30 pm
Speaker: 
Zoë M. McLaren
University of Michigan
Abstract: 

Although anti-retroviral therapy (ART) improves economic outcomes for HIV patients and their households, little is known about the spillover effects of ART rollout on other community members, including HIV-infected persons not yet on ART and people not infected with HIV. Community spillover effects of ART scale-up are theoretically ambiguous.  To date, no study has assessed the distribution of labor market impacts by HIV status and by household exposure to ART.  This study uses data from a demographic surveillance site in rural South Africa to examine the distribution of the employment effects of ART scale-up. The data include information on demographics, labor market outcomes, HIV biomarkers, and ART program participation. We estimate fixed effect models comparing labor market outcomes for respondents living close to ART clinics with those living farther away.  Between 2004-2011, employment rates rose by approximately 7 percentage points for respondents less than 5km from the nearest ART clinic relative to those 5-12kms away. Employment increased the most for HIV-infected people, but large gains in employment were observed for HIV-uninfected community members as well.  Our results present new evidence of positive spillover effects of ART scale-up on employment of HIV-uninfected community members, through channels that operate outside the household.  The larger implication of our results is that the literature is likely to have underestimated the drain on the total economy caused by the HIV epidemic by failing to adequately measure the negative economic spillovers on HIV-negatives.