Abstract
Cash payments to improve health outcomes have been used for many years; however, their use for HIV prevention is new and the impact not yet well understood. We provide a brief background on the rationale behind using cash to improve health outcomes, review current studies completed or underway using cash for prevention of sexual transmission of HIV, and outline some key considerations on the use of cash payments to prevent HIV infections. We searched the literature for studies that implemented cash transfer programs and measured HIV or HIV-related outcomes. We identified 16 studies meeting our criteria; 10 are completed. The majority of studies have been conducted with adolescents in developing countries and payments are focused on addressing structural risk factors such as poverty. Most have seen reductions in sexual behavior and one large trial has documented a difference in HIV prevalence between young women getting cash transfers and those not. Cash transfer programs focused on changing risky sexual behaviors to reduce HIV risk suggest promise. The context in which programs are situated, the purpose of the cash transfer, and the population will all affect the impact of such programs; ongoing RCTs with HIV incidence endpoints will shed more light on the efficacy of cash payments as strategy for HIV prevention.
Similar content being viewed by others
References
Grant RM, Lama JR, Anderson PL, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010;363(27):2587–99.
Gray RH, Kigozi G, Serwadda D, et al. Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial. Lancet. 2007;369(9562):657–66.
Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R, Puren A. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 trial. PLoS Med. 2005;2(11):e298.
Abdool Karim Q, Abdool Karim SS, Frohlich JA, et al. Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science. 2010;329(5996):1168–74.
Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505.
Padian NS, McCoy SI, Karim SS, et al. HIV prevention transformed: the new prevention research agenda. Lancet. 2011;378(9787):269–78.
Hankins C, Forsythe S, Njeuhmeli E. Voluntary medical male circumcision: an introduction to the cost, impact, and challenges of accelerated scaling up. PLoS Med. 2011;8(11):e1001127.
Dieffenbach CW. Preventing HIV transmission through antiretroviral treatment-mediated virologic suppression: aspects of an emerging scientific agenda. Curr Opin HIV AIDS. 2012;7(2):106–10.
Stringer EM, Chi BH, Chintu N, et al. Monitoring effectiveness of programmes to prevent mother-to-child HIV transmission in lower-income countries. Bull World Health Organ. 2008;86(1):57–62.
Dugger C. African studies give women hope in HIV fight. New York Times 2010.
Shetty P. Cash cure for the AIDS epidemic? Nature. 2011. http://www.nature.com/news/2011/110606/full/news.2011.351.html. Accessed June 16 2011.
McCoy SI, Watts CH, Padian NS. Preventing HIV infection: turning the tide for young women. Lancet. 2010;376(9749):1281–2.
Fiszbein A, Schady N. Conditional cash transfers: reducing present and future poverty. Washington, DC: World Bank; 2009.
Arnold C, Conway T, Greenslade M. Cash transfers evidence paper. 2011. http://webarchive.nationalarchives.gov.uk/+/http://www.dfid.gov.uk/Documents/publications1/cash-transfers-evidence-paper.pdf. Accessed July 12, 2011.
Lagarde M, Haines A, Palmer N. The impact of conditional cash transfers on health outcomes and use of health services in low and middle income countries. Cochrane Database Syst Rev (Online) 2009;4:CD008137.
Lagarde M, Haines A, Palmer N. Conditional cash transfers for improving uptake of health interventions in low- and middle-income countries: a systematic review. JAMA, J Am Med Assoc. 2007;298(16):1900–10.
Volpp KG, Asch DA, Galvin R, Loewenstein G. Redesigning employee health incentives—lessons from behavioral economics. N Engl J Med. 2011;365(5):388–90.
Petry NM, Weinstock J, Alessi SM, Lewis MW, Dieckhaus K. Group-based randomized trial of contingencies for health and abstinence in HIV patients. J Consult Clin Psychol. 2010;78(1):89–97.
Ledgerwood DM. Contingency management for smoking cessation: where do we go from here? Curr Drug Abuse Rev. 2008;1(3):340–9.
Paul-Ebhohimhen V, Avenell A. Systematic review of the use of financial incentives in treatments for obesity and overweight. Obes Rev. 2008;9(4):355–67.
Dutra L, Stathopoulou G, Basden SL, Leyro TM, Powers MB, Otto MW. A meta-analytic review of psychosocial interventions for substance use disorders. Am J Psychiatry. 2008;165(2):179–87.
Prendergast M, Podus D, Finney J, Greenwell L, Roll J. Contingency management for treatment of substance use disorders: a meta-analysis. Addiction. 2006;101(11):1546–60.
Lussier JP, Heil SH, Mongeon JA, Badger GJ, Higgins ST. A meta-analysis of voucher-based reinforcement therapy for substance use disorders. Addiction. 2006;101(2):192–203.
Petry NM, Petrakis I, Trevisan L, et al. Contingency management interventions: from research to practice. Am J Psychiatry. 2001;158(5):694–702.
Stitzer ML, Vandrey R. Contingency management: utility in the treatment of drug abuse disorders. Clin Pharmacol Ther. 2008;83(4):644–7.
Education and HIV/AIDS a window of hope. Washington, DC: World Bank; 2002.
Karim QA. A proof of concept cluster randomised controlled trial to evaluate the impact of a cash incentivised prevention intervention to reduce HIV infection in high school learners in rural KwaZulu-Natal, South Africa. 2012. http://clinicaltrials.gov/ct2/show/NCT01187979. Accessed May 31 2012.
Minnis AM. Yo Puedo: future opportunities for youth. 2012. http://projectreporter.nih.gov/project_info_description.cfm?aid=8124903&icde=11152236&ddparam=&ddvalue=&ddsub=. Accessed May 31 2012.
Galarraga O. Conditional cash transfers to prevent sexually transmitted infections in Mexico. 2012. http://projectreporter.nih.gov/project_info_description.cfm?aid=7744648&icde=11152236&ddparam=&ddvalue=&ddsub=. Accessed May 31 2012.
Kohler H-P, Thornton R. Conditional cash transfers and HIV/AIDS prevention: unconditionally promising? World Bank Econ Rev. 2011;26(2):165–90.
Baird SJ, Garfein RS, McIntosh CT, Ozler B. Effect of a cash transfer programme for schooling on prevalence of HIV and herpes simplex type 2 in Malawi: a cluster randomised trial. Lancet. 2012;379(9823):1320–9.
Pettifor A. Effects of cash transfer and community mobilization in young South African women. 2012. http://projectreporter.nih.gov/project_info_details.cfm?aid=8056817&icde=11152347. Accessed May 31 2012.
Personal communications with Deanna Kerrigan 2012.
Kohler H, Thornton RL. Conditional cash transfers and HIV/AIDS prevention: unconditionally promising. University of Michigan; 2010.
Siegfried N, van der Merwe L, Brocklehurst P, Sint TT. Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection. Cochrane Database Syst Rev (Online). 2011;7:CD003510.
Thornton RL. The demand for, and impact of, learning HIV status. Am Econ Rev. 2008;98(5):1829–63.
El-Sadr W, Branson B. Evaluating methods to increase HIV testing, access to HIV care, and HIV prevention strategies. 2012. http://clinicaltrials.gov/ct2/show/NCT01152918?term=Wafaa&rank=4. Accessed May 31 2012.
Simoni JM, Amico KR, Pearson CR, Malow R. Strategies for promoting adherence to antiretroviral therapy: a review of the literature. Curr Infect Dis Rep. 2008;10(6):515–21.
Rosen MI, Dieckhaus K, McMahon TJ, et al. Improved adherence with contingency management. AIDS Patient Care STDS. 2007;21(1):30–40.
Sorensen JL, Haug NA, Delucchi KL, et al. Voucher reinforcement improves medication adherence in HIV-positive methadone patients: a randomized trial. Drug Alcohol Depend. 2007;88(1):54–63.
Adato M, Roopnaraine T. Women’s status, gender relations, and conditional cash transfers. In: Adato M, Hoddinott J, editors. Conditional cash transfers in Latin America. Baltimore: Johns Hopkins University Press; 2010. p. 284–314.
Rivera L, Hernández B, Castro R. Asociación entre la violencia de pareja contra las mujeres de las zonas urbanas en 69 pobreza extrema y la incorporación al Programa Oportunidades. In: López M, Salles V, editors. El Programa Oportunidades examinado desde el género. Mexico City: Programa de Desarrollo Oportunidades; 2006.
Ssewamala FM, Han CK, Neilands TB, Ismayilova L, Sperber E. Effect of economic assets on sexual risk-taking intentions among orphaned adolescents in Uganda. Am J Public Health. 2010;100(3):483–8.
Hallfors D, Cho H, Rusakaniko S, Iritani B, Mapfumo J, Halpern C. Supporting adolescent orphan girls to stay in school as HIV risk prevention: evidence from a randomized controlled trial in Zimbabwe. Am J Public Health. 2011;101(6):1082–8.
Cho H, Hallfors DD, Mbai II, et al. Keeping adolescent orphans in school to prevent human immunodeficiency virus infection: evidence from a randomized controlled trial in Kenya. J Adolesc Health. 2011;48(5):523–6.
Handa S. Social cash transfers, household risk and HIV prevention in Kenya. 2012. http://projectreporter.nih.gov/project_info_description.cfm?aid=8070982&icde=11152236&ddparam=&ddvalue=&ddsub=. Accessed May 31 2012.
Personal communications with Sudhanshu Handa 2012.
Duflo ED, Pascaline D, Kremer M, Sinei S. Education and HIV/AIDS prevention: evidence from a randomized evaluation in Western Kenya. Washington, DC: World Bank; 2006.
Stevens-Simon C, Dolgan JI, Kelly L, Singer D. The effect of monetary incentives and peer support groups on repeat adolescent pregnancies. A randomized trial of the Dollar-a-Day Program. JAMA, J Am Med Assoc. 1997;277(12):977–82.
de Walque D, Dow WH, Nathan R, et al. Incentivising safe sex: a randomised trial of conditional cash transfers for HIV and sexually transmitted infection prevention in rural Tanzania. BMJ Open. 2012;2:e000747.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Pettifor, A., MacPhail, C., Nguyen, N. et al. Can Money Prevent the Spread of HIV? A Review of Cash Payments for HIV Prevention. AIDS Behav 16, 1729–1738 (2012). https://doi.org/10.1007/s10461-012-0240-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10461-012-0240-z