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South Africa's disability grants program is tied to its HIV/AIDS recoveryprogram, such that individuals who are ill enough may qualify. Qualification ishistorically tied to a CD4 count of 200 cells/mm3, which improve when a personadheres to antiretroviral therapy. This creates a potential unintendedconsequence where poor individuals, faced with potential loss of their income,may choose to limit their recovery through non-adherence. To test formanipulation caused by grant rules, we identify differences in disability grantrecipients and non-recipients' rate of CD4 recovery around the qualificationthreshold, implemented as a fixed-effects difference-in-difference around thethreshold. We use data from the Africa Health Research Institute Demographicand Health Surveillance System (AHRI DSS) in rural KwaZulu-Natal, South Africa,utilizing DG status and laboratory CD4 count records for 8,497 individuals totest whether there are any systematic differences in CD4 recover rates amongeligible patients. We find that disability grant threshold rules causedrecipients to have a relatively slower CD4 recovery rate of about 20-30cells/mm3/year, or a 20% reduction in the speed of recovery around thethreshold.

Disability for HIV and Disincentives for Health: The Impact of South Africa's Disability Grant on HIV/AIDS Recovery