The Effect of Needle Exchange Program on HIV and Hepatitis: Evidence from Sweden

I exploit the natural experiment in Sweden to study how needle exchange programs affect the healthcare visits of individuals that are diagnosed with HIV and hepatitis. Current studies on needle exchange programs’ effects on HIV and hepatitis are being questioned in reviews, as the current studies suffer from selection bias due to inadequate research design. To overcome the selection bias, I am using two econometric methods, the synthetic control method and the staggered difference-in- difference to study the impact of needle exchange programs on HIV. I am using municipality-level panel data on the number of patients who have had one inpatient care or doctor visit in the outpatient care with HIV or hepatitis diagnosis from the years 2008 to 2020. The main findings are (i) the results suggest that needle exchange programs increase the number of hepatitis healthcare visits and decrease the number of HIV healthcare visits. (ii) The effect of NEP on HIV and hepatitis healthcare visits show heterogeneous effects across adoption groups and calendar year, therefore the staggered difference-in-difference provides better estimates than the synthetic control method.