Awareness and AIDS :A Political Economy Perspective

At the height of HIV/AIDS epidemics, across African countries prevention policieswere unrelated to HIV/AIDS prevalence. Even when successful, they were often unsta-ble or reversed. To explain these puzzles, we propose a simple political economy modelthat examines joint determination of prevention policies and the epidemic dynamics.Prevention a¤ects both behavior and the perception of the role of policies in ghtingAIDS. Behavioral changes induced by the policy, in turn, reduce the infection risk forsexually active agents, which creates political support for future policies. The two-wayrelationship between prevention policy and awareness generates two stable steady-stateequilibria. The low-prevalence equilibrium is fragile. Reduced transmission rates havean ambiguous impact on prevalence rates as they also imply less active preventionpolicies. An empirical analysis of the determinants of public support for HIV/AIDSpolicies using the 2005 Afrobarometer shows that high prevalence rates translate intopublic support for prevention policies only in countries which carried out active pre-vention campaigns in the past. Our framework extends to a large class of public healthpolicies under which awareness partly follows from the policies themselves.