Rewarding Safer Sex : Conditional Cash Transfers for HIV/STI Prevention
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World Bank Group, Washington, DC
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Incentive-based policies have been shown
to be powerful in many areas of behavior, but have rarely
been tested in the sexual domain. The Rewarding Sexually
Transmitted Infection Prevention and Control in Tanzania
(RESPECT) study is a randomized controlled trial testing the
hypothesis that a system of rapid feedback and positive
reinforcement that uses cash as the primary incentive can be
used to reduce risky sexual activity among young people,
male and female, who are at high risk of HIV infection. The
study enrolled 2,399 participants in 10 villages in rural
southwest Tanzania. The intervention arm received
conditional cash transfers that depended on negative results
of periodic screenings for sexually transmitted infections,
an objectively measured marker for risky sexual behavior.
The intervention arm was further divided into two subgroups,
one receiving a high value payment of up to $60 over the
course of the study ($20 payments every four months) and the
other receiving a lower value payment of up to $30 ($10
payments every four months). At the end of the one year of
intervention, the results showed a significant reduction in
sexually transmitted infections in the group that was
eligible for the $20 payments every four months, but no such
reduction was found for the group receiving the $10
payments. The effects were stronger among the lower
socioeconomic and higher risks groups. The results of a
post-intervention follow-up survey conducted one year after
discontinuing the intervention indicate a sustained effect
among males, but not among females.
Palabras clave
ABSTINENCE, ADOLESCENT, ADOLESCENT FEMALES, AGED, AIDS EPIDEMIC, AIDS PREVENTION, ANAL SEX, BEHAVIOR CHANGE, BIOLOGICAL MARKERS, BLOOD SAMPLES, CHEMOTHERAPY, CHLAMYDIA, CLINICS, COMMERCIAL SEX, CONDOM, CONDOM USE, CONDOMS, CONSISTENT CONDOM USE, COUNSELLING, DEVELOPING COUNTRIES, DEVELOPMENT POLICY, DEVELOPMENTAL PSYCHOLOGY, DIAGNOSIS, DISEASE PREVENTION, ECONOMIC STATUS, EPIDEMIC, FEMALE, FEMALES, FEWER PEOPLE, FORMAL EDUCATION, GENDER, GENITAL SECRETIONS, GONORRHEA, GONORRHOEA, HEALTH EDUCATION, HEALTH FACILITIES, HEALTH RISKS, HERPES, HERPES SIMPLEX, HERPES SIMPLEX VIRUS, HIV, HIV INFECTION, HIV POSITIVE, HIV PREVENTION, HIV TESTING, HIV/AIDS, HOUSEHOLD INCOME, HUMAN DEVELOPMENT, INFECTION PREVENTION, INTERVENTION, MALE SEX, MARITAL SEX, MARITAL STATUS, MASS COMMUNICATION, MEDICAL RESEARCH, MEDICAL TREATMENT, MINISTRY OF HEALTH, MULTIPLE PARTNERS, NEGATIVE EFFECTS, NEW INFECTIONS, POLICY DISCUSSIONS, POLICY RESEARCH, POLICY RESEARCH WORKING PAPER, POPULATION AND DEVELOPMENT, POPULATION REFERENCE BUREAU, PREVALENCE, PREVALENCE OF CHLAMYDIA, PREVALENCE OF SYPHILIS, PREVENTION INTERVENTIONS, PREVENTION STRATEGIES, PROGRESS, PROSTITUTION, PSYCHOLOGISTS, PUBLIC HEALTH, PUBLIC SERVICES, RESEARCH COMMUNITIES, RESPECT, RISK BEHAVIORS, RISK REDUCTION, RISKY BEHAVIOR, RISKY SEX, RISKY SEXUAL BEHAVIOR, RISKY SEXUAL BEHAVIORS, RURAL COMMUNITIES, SAFE SEX, SAFER SEX, SCHOOL ATTENDANCE, SEX, SEX WITH MEN, SEX WORKERS, SEXUAL ACTIVITY, SEXUAL BEHAVIORS, SEXUAL BEHAVIOUR, SEXUAL CONTACT, SEXUAL ENCOUNTERS, SEXUAL INTERCOURSE, SEXUAL PARTNER, SEXUAL PARTNERS, SEXUAL PARTNERSHIP, SEXUAL PARTNERSHIPS, SEXUAL PRACTICES, SEXUAL RELATIONSHIPS, SEXUALITY, SEXUALLY ACTIVE, SEXUALLY TRANSMITTED DISEASE, SEXUALLY TRANSMITTED DISEASES, SEXUALLY TRANSMITTED INFECTION, SEXUALLY TRANSMITTED INFECTIONS, SM, SOCIAL NORMS, SOCIOECONOMIC STATUS, SPOUSE, SPOUSES, STIS, SUSTAINABLE DEVELOPMENT, SYMPTOMS, SYPHILIS, TREATMENT, TRICHOMONAS, UNPROTECTED SEX, USE OF CONDOMS, VIRUS, VULNERABILITY, YOUNG GIRLS, YOUNG PEOPLE, YOUTH, YOUTHS