Author ORCID Identifier

https://orcid.org/0009-0008-1056-8261

Date of Award

8-8-2023

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Economics

First Advisor

Dr. Thomas A. Mroz

Second Advisor

Dr. Kirsty A. Clark

Third Advisor

Dr. Lauren Hoehn-Velasco

Fourth Advisor

Dr. Keith Teltser

Abstract

This dissertation has two chapters that broadly fall in the fields of health and public economics. The first paper explores the effect an innovation in HIV/AIDS treatment of the suicide rates of affected population. The second chapter is coauthored with Sherajum Monira Farin and Shyam Raman and explores how states respond to exogenous changes in federal funding for the provision of life-saving HIV/AIDS treatments.

Chapter 1: The introduction of Highly Active Antiretroviral Therapy (HAART) in 1995, transformed the prognosis of an HIV infection from a death sentence to a manageable chronic health condition. Using a difference-in-differences and triple-difference strategy, this paper exploits spatial and demographic variation in HIV incidence at the time HAART treatment was introduced and finds that, in addition to reducing HIV/AIDS deaths, the introduction of HAART led to a disproportionate decrease in suicide rates for men aged 25 to 44. Estimates suggest that HAART saved approximately 500 men aged 25 to 44 from suicide each year following its introduction.

Chapter 2: As part of the Ryan White HIV/AIDS program, the AIDS Drug Assistance Program (ADAP) serves as a payer of last resort for people living with HIV (PLWH) who are uninsured or underinsured and have a low income. ADAP provides recipients with access to life-saving antiretroviral treatments which transforms an HIV diagnosis from a death sentence to a manageable chronic health condition. The ADAP program is funded through a combination of federal and state funds but is administered by the state. I exploit a rule change which was part of the 2006 reauthorization of the Ryan-White Care Act and resulted in an exogenous shock to federal funding for ADAPs. Using this unique setting, the study finds that changes in federal contributions to ADAPs have a near dollar-to-dollar effect on expenditures and increased federal funding results in an increased number of clients served. These findings underscore the importance of federal support for ADAPs in providing critical care for people living with HIV.

DOI

https://doi.org/10.57709/35881789

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