Potential Applications of Conditional Cash Transfers for Prevention of Sexually Transmitted Infections and HIV in Sub-Saharan Africa
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World Bank, Washington, DC
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A growing number of developing countries
have introduced conditional cash transfer programs that
provide money to poor families with certain contingencies
attached - such as requiring school attendance or regular
immunization and health check-ups. As the popularity of
conditional cash transfer programs has grown,
experimentation with potential applications in other areas
of health, such as sexual and reproductive health, and HIV
prevention, in particular, has also increased. Evaluations
of conditional cash transfer programs have focused almost
exclusively on uptake of health and educational services,
which make relatively low demands of participants compared
with more complex interventions, which require the cessation
of risky behaviors, such as smoking, obesity, and substance
abuse. The literature on contingency management - based on
the principle that behavioral change occurs when appropriate
behaviors are reinforced and rewarded - provides a richer
picture of the complexity of the use of conditionality to
encourage healthy behavioral change. This paper examines
developing countries' experiences with conditional cash
transfer programs and the results of trials in clinical
settings on the efficacy of contingency management, and
addresses their relevance for designing conditional cash
transfer programs to address risky sexual behavior and
promote the prevention of sexually transmitted infections
and HIV in Sub-Saharan Africa.
Palabras clave
ABSTINENCE, ADDICTION, ADHERENCE TO MEDICATIONS, ADOLESCENT, ADOLESCENT GIRLS, AGED, AGGRESSIVE, AIDS EPIDEMIC, AIDS ORPHANS, AIDS PANDEMIC, AIDS PATIENT, AIDS PREVENTION, AIDS VACCINE, AIDS VIRUS, ALCOHOL, ALCOHOL ABUSE, ALCOHOL DEPENDENCE, ALCOHOL USE, ANAL SEX, ANTENATAL CARE, ANTIBIOTICS, BABY, BEHAVIOR CHANGE, BEHAVIORAL CHANGE, BEHAVIORAL CHANGES, BIOLOGICAL MARKERS, BIOLOGICAL OUTCOMES, BIRTH RATES, BLOOD SPECIMEN, BLOOD TESTS, CHILD HEALTH, CHLAMYDIA, CIRCUMCISION, CLINICAL PSYCHOLOGY, CLINICAL TRIALS, CLINICS, COCAINE, COMMERCIAL SEX, COMMERCIAL SEX WORK, CONDOM, CONDOM PROMOTION, CONDOM USE, CONDOMS, CONTRACEPTION, CONTRACEPTIVE PREVALENCE, CONTRACEPTIVE USE, COST EFFECTIVENESS, COUNSELING INTERVENTION, DECISION MAKING, DEVELOPING COUNTRIES, DEVELOPMENT POLICY, DEVELOPMENTAL PSYCHOLOGY, DIETS, DISEASE, DISEASE CONTROL, DISEASE TRANSMISSION, DRUG ABUSE, DRUGS, ECONOMIC OPPORTUNITY, EDUCATIONAL SERVICES, ELDERLY, FAMILIES, FAMILY MEMBER, FAMILY PLANNING, FAMILY SIZE, FERTILITY, FINANCIAL CONSTRAINTS, FOCUS GROUP DISCUSSIONS, GLOBAL ACTION, GLOBAL AIDS EPIDEMIC, GLOBAL HEALTH, GONORRHEA, GROUP THERAPY, HEALTH CARE, HEALTH CARE SERVICES, HEALTH EDUCATION, HEALTH EXPERTS, HEALTH IMPACT, HEALTH INTERVENTIONS, HEALTH OUTCOMES, HEALTH PLANNING, HEALTH POLICY, HEALTH RISKS, HEALTH SERVICES, HEALTH SYSTEMS, HIV, HIV INFECTION, HIV INFECTIONS, HIV PREVENTION, HIV TESTING, HIV TRANSMISSION, HOUSEHOLD INCOME, HUMAN CAPITAL, HUMAN DEVELOPMENT, ILLNESS, IMMUNIZATION, INDIVIDUAL CHOICES, INFECTION RATES, INTERNATIONAL FAMILY PLANNING, INTERNATIONAL FAMILY PLANNING PERSPECTIVES, INTERVENTION, KIDS, LATIN AMERICAN, MALE CIRCUMCISION, MASS COMMUNICATION, METHADONE, METHADONE PATIENTS, MOTHER, MOTHER-TO-CHILD, MOTHER-TO-CHILD TRANSMISSION, NEGATIVE HEALTH CONSEQUENCES, NEW INFECTIONS, NEWBORNS, NUTRITIONAL STATUS, NUTRITIONAL SUPPLEMENTS, OBESITY, OCCUPATIONAL MEDICINE, OVERWEIGHT, PATIENT, PATIENT CARE, PATIENTS, PEER PRESSURE, PILOT PROJECTS, POLICY GOALS, POLICY RESEARCH, POLICY RESEARCH WORKING PAPER, POOR FAMILIES, POOR HOUSEHOLDS, POOR POPULATIONS, POPULATION AND DEVELOPMENT, POVERTY ALLEVIATION, POVERTY REDUCTION, PREGNANCIES, PREGNANCY, PREGNANT WOMEN, PREVALENCE RATES, PREVENTION ACTIVITIES, PREVENTION COUNSELING, PREVENTION EFFORTS, PREVENTION OF MOTHER, PREVENTION OF MOTHER-TO-CHILD TRANSMISSION, PREVENTION STRATEGIES, PREVENTIVE HEALTH, PREVENTIVE HEALTH CARE, PREVENTIVE MEDICINE, PRIMARY EDUCATION, PRIVACY, PRIVATE PROVIDERS, PROGRESS, PSYCHIATRY, PSYCHOLOGISTS, PSYCHOPHARMACOLOGY, PUBLIC HEALTH, PUBLIC SERVICE, PUBLIC SERVICE PROVIDERS, PUBLIC SERVICES, RANDOMIZED CONTROLLED TRIALS, REPRODUCTIVE HEALTH, REPRODUCTIVE HEALTH POLICY, REPRODUCTIVE HEALTH SERVICES, RESPECT, RISK BEHAVIOR, RISK BEHAVIORS, RISK-TAKING BEHAVIOR, RISKY BEHAVIOR, RISKY BEHAVIORS, RISKY SEX, RISKY SEXUAL BEHAVIOR, RISKY SEXUAL BEHAVIORS, RURAL AREAS, RURAL POPULATION, SAFE BLOOD, SCHOOL ATTENDANCE, SCHOOLS, SCREENING, SELF-TREATMENT, SERVICE PROVIDERS, SEX, SEX WORK, SEX WORKERS, SEXUAL ACTIVITY, SEXUAL BEHAVIORS, SEXUAL CONTACT, SEXUAL ENCOUNTERS, SEXUAL PARTNERS, SEXUAL PLEASURE, SEXUAL PRACTICES, SEXUAL RELATIONSHIP, SEXUALLY TRANSMITTED INFECTION, SEXUALLY TRANSMITTED INFECTIONS, SMOKERS, SMOKING, SMOKING CESSATION, SOCIAL SUPPORT, STD, STDS, STERILIZATION, STIS, SUB-SAHARAN AFRICA, SUBSTANCE ABUSE, SYMPTOMS, TEEN, TEEN PREGNANCIES, TEENS, THERAPEUTIC APPROACH, TOBACCO, TOBACCO CONTROL, TOXICOLOGY, TRANSMISSION RATES, TRICHOMONAS, UNAIDS, UNPROTECTED SEX, URBAN AREAS, VACCINATION, VACCINATION PROGRAMS, VACCINES, VIRAL LOAD, VIRAL LOADS, VIRUS, VOLUNTARY COUNSELING, WEIGHT GAIN, WEIGHT LOSS, WEIGHT REDUCTION, YOUNG CHILDREN, YOUNG GIRLS, YOUNG PEOPLE, YOUTH