The value of knowing is not always positive





An interesting article by Ciancio et al. (2025) which examines the impact of learning one has HIV when no treatment is available.

When there is no treatment available for a life-threatening disease, providing personal health information could lead to despair or fatalistic behaviors resulting in negative health outcomes. We document this possibility utilizing an experiment in Malawi that randomized incentives to learn HIV testing results in a context where antiretroviral treatment was not yet available. Six years after the experiment, among HIV-positive individuals, those who learned their status were 23 percentage points less likely to survive than those who did not, with effects persisting after 15 years. Receiving an HIV-positive diagnosis resulted in riskier health behaviors, greater anxiety, and higher discount rates.

A key question to ask is whether the value of transparency and the patient’s ‘right to know’ should or should not outweigh negative health impacts from patient knowledge of potentially untreatable disease. The full study is here.



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