Eliz­a­beth Pisani, author of The Wis­dom of Whores, writes about HIV from var­i­ous per­spec­tives: social, sci­en­tific, and polit­i­cal. In a recent arti­cle she notes how per­sonal incen­tives are enough to over­come the stigma of HIV-infection.

Malawi is sus­pend­ing its pay­ments to HIV-infected civil ser­vants because so many unin­fected peo­ple are try­ing to cash in. A third of Malawi’s 120,000 civil ser­vants have reg­is­tered as HIV pos­i­tive. That puts HIV preva­lence among gov­ern­ment work­ers at twice the national rate of 14 percent.

It reminds me of sto­ries that sur­faced in China when the gov­ern­ment started pro­vid­ing free school­ing for the kids of peo­ple with HIV. China being China, it wasn’t long before there was a sec­ondary mar­ket in HIV-infected blood.

Stigma exists because we allow it to, because we rein­force it by tip­toe­ing around it. The bull­dozer of per­sonal incen­tives can break through stigma in exactly the same way as it can break through cor­rup­tion, poor pro­duc­tiv­ity and other areas of human endeav­our. If we have to bribe our way into greater open­ness about HIV, why not?

via Chris Blattman