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Health Economics
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Health Economics
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Health Economics
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The effect of HIV prevention products on incentives to supply condomless commercial sex among female sex workers in South Africa

Authors: Fern Terris-Prestholt; Maria A. Cabrera-Escobar; Sinead Delany-Moretlwe; Robyn Eakle; Robyn Eakle; Matthew Quaife; Matthew Quaife; +2 Authors

The effect of HIV prevention products on incentives to supply condomless commercial sex among female sex workers in South Africa

Abstract

AbstractEvidence suggests that economic factors play an important role in commercial sex work, in particular that condomless sex commands a price premium relative to condom‐protected sex. This paper explores whether the use of a new HIV prevention product, with 100% efficacy but modeled after pre‐exposure prophylaxis (PrEP), could change the price and quantity of condomless commercial sex supplied. We collected stated preference data from 122 HIV‐negative female sex workers in urban South Africa, using a repeated choice experiment to simulate the impact of using PrEP on choices. Results suggest that the price premium for condomless sex would decrease by 73% with PrEP use and the quantity of condomless sex is predicted to increase by a factor of 2.27. Act price does not significantly affect choices without protection but strongly influences choices under full HIV protection. The utility offered by condoms reduces by around 15% under PrEP use. Because new HIV prevention products do not protect against other STIs or pregnancy, the unintended consequences of introducing HIV prevention products should be closely monitored, whereas users should not face stigma or blame for reacting rationally to exogenous changes to market conditions.

Keywords

Adult, Safe Sex, 330, HIV prevention, 610, Economic, HIV Infections, Safe Sex - statistics & numerical data, risk compensation, Condoms, condom differential, South Africa, Sex Workers - statistics & numerical data, Models, Pre-Exposure Prophylaxis - statistics & numerical data, Humans, Pre-Exposure Prophylaxis - economics, Research Articles, Condoms - statistics & numerical data, Motivation, Sex Workers, HIV Infections - prevention & control, Models, Economic, Female, Pre-Exposure Prophylaxis, economics of sex work

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    Top 10%
    influence
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    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
19
Top 10%
Average
Top 10%
Green
hybrid