Lottery Ticket Approach Leads to Reduction in HIV Prevalence | Hacker News Reader

Lottery Ticket Approach Leads to Reduction in HIV Prevalence

foreignpolicy.com

37 pointskposehn16 comments

So, if I've got this right, sexually transmitted diseases are transmitted mostly by people with a high tolerance for risk (people who tend to engage in risky behavior). Also, people with a high tolerance for risk tend to overvalue lotteries. So they targeted that population by incorporating a lottery into their social program.

Clever.

This is indeed where the article goes, but I suggest risk is overstated as a factor here.

Everyone knows they should be tested, so an incentive to actually go and do it doesn't need to be large or meaningful. This also acts as a genuine acknowledgement by the state that this is important and that it's without taboo.

Testing reduces everyone's chance of being infected - so it ought to reduce risk-takers' chances proportionately more, lottery or not.

I'm not sure how I feel about using "game-y" things to convince people to do stuff, especially when we're talking about serious stuff.

In Portugal a similar strategy was used to hinder tax evasion, where you got a chance (a ticket, so to speak) to win a car for each receipt you demanded on every purchase you made. (I'm oversimplifying a bit, I think)

It somehow feels like cheating/manipulating people, since we are terrible at estimating very small odds, making this kind of stuff an effective strategy with a very small cost for whoever provides the prize.

I agree. To me it also has echos of colonialism, as there's an overtone of "We just can't get the residents in Lesotho to stop contracting HIV so we, the (European) rich non-natives, are going to bribe the poor natives into taking care of themselves. Aren't we just so benevolent!" It reminds me of the picture of the Turkish officials with bread in the Armenian genocide.[1]

[1]http://rarehistoricalphotos.com/turkish-official-teasing-sta...

> I'm not sure how I feel about using "game-y" things to convince people to do stuff, especially when we're talking about serious stuff.

I see it as a tool, usable for both good and bad. Taking manipulation of others out of the equation: Would you have concerns "gameifying" things for yourself, on your own behalf, as a form of self manipulation?

I wouldn't, because it would be a decision by me and for me. It is precisely the manipulative aspect that I am concerned with.

I am not against it, in this specific case, but the "end justifying the means" message it seems to send doesn't ring too well.

Your chance of winning money may be tiny, but your chance of actually not dying of a AIDS went way up. Pay for the infinitessimal chance of a coffee, receive a donut instead. Tasty, tasty donut.

Yeah, but the will to actually not dying of AIDS should be taught somehow. Otherwise, you are covering up the problem. In a year the lottery goes away, AIDS comes up again.

Just like fixing a bug superficially instead of going for the root.

If you wanted donuts you could've just get them in the first place.

I am not saying the results aren't positive, or that they aren't better than nothing. But I don't think this solves anything in the long term, and the manipulative and "the ends justify the means" approach rings the "should this really be done?" alarm bell in my mind.

Weel, in the long term, the only thing that solves anything is probably a vaccine/cure. There are other initiatives also.

If this is true, then the alarm in my mind won't ring: The lotteries led to a 21.4 percent reduction in HIV incidence among participants over a two-year period, and a reduction of more than 60 percent among participants identified as “risk-loving individuals” — those who were identified at the study’s start as people who enjoyed risky behavior."

One reason that HIV infection is high is because it's a taboo subject. The government can affect this taboo status through education, yes, and also this way.

Punishing HIV positive people (for example, by making it illegal for them to enter the country) contributes to this taboo. Giving a government-mandated lottery ticket mitigates the taboo, and it's my belief that this will have lasting positive consequences even after the lottery goes away.

Also, people not getting infected today are not infecting people tomorrow (exponentially). Stopping infections today is exactly the right thing to do for the long-term.

I've seen the same thing in Shanghai.

I understand that the mean is discutable but here in all of these case, the goal seems OK: less AIDS, less tax evasion.

Until people realize that if you reduce the number of HIV negative people, the odds of winning for those left increase.

Perfect is the enemy of good.

Of course :) Let's not stop striving for improvement though.

This kind of thing is apparently known as "Nudge theory": http://en.wikipedia.org/wiki/Nudge_theory

It happens all the time everywhere anyway. Advertising, regular non-AIDS-related lotteries, law enforcement, even simple things like traffic signals, all are "game-y" to some extent. At least this instance is using it to accomplish something good, instead of just convincing people to consume a different brand of sugar water.

I understand the reluctance to use persuasive tactics like this. But in a practical sense, if being principled means avoiding anything "game-y" then all you're saying is that the world is to be run by non-principled people.

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