Risk beliefs, intensive information and demand for preventative health care

This randomised-controlled experiment tested the hypothesis that demand for a recently available, free HIV prevention product responds to a combination of – adjustment of prior beliefs on relatives risks of HIV infection and benefits of prevention and clinic referral enabling access to the product. The preventative health product of interest is Pre-exposure Prophylaxis for HIV (PrEP). The experiment took place in 6 communities in Manicaland Province, Eastern Zimbabwe. The communities include two peri-urban small towns, three rural communities and one high-density urban suburb. Each community is served by one or more health care facilities that offers HIV services. Baseline data were gathered between July 2018 and December 2019.

The intervention comprised three parts – an intensive information component, sign-up for a call with a nurse to discuss PrEP and provision of a clinic referral for PrEP initiation. The information component involved a digital self-administered feedback-based quiz on relative risks of HIV infection and reduction in risks from condom use and PrEP. Following this, individuals could sign-up for a call with nurse from their local clinic to discuss PrEP. Finally, individuals were provided with a referral to their local clinic to initiate PrEP. The primary outcome was take-up of PrEP within six months. Secondary outcomes include the effects on risk beliefs and sexual behaviour. A rare feature of the study is the availability of baseline measures of time preferences, measured with monetarily incentivized economic experiments. This allows analysis of heterogeneity in demand for prevention by present-biased preferences.