Criminal Prosecution and HIV-related Risky Behavior

We evaluate the consequences of prosecuting HIV+ people who expose others to the risk of infection. We show that the effect of aggressive prosecutions on the spread of HIV is a priori ambiguous. Aggressive prosecutions tax risky behavior and thus deter unsafe sex and limit the number of sexual partners. However, such penalties might also create unique incentives for having sex with more promiscuous partners such as prostitutes and consequently increase the spread of HIV. We test these predictions using unique nationally representative data on the sexual activity and prosecutions of HIV+ persons. We find that more aggressive prosecutions are associated with a reduction in the number of sexual partners and increased likelihood of safe sex. However, they are also associated with increased likelihood of having sex with prostitutes and not disclosing HIV+ status. Overall, our estimates imply that doubling the prosecution rate could decrease the number of new HIV infections by 12% over a ten-year period.