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Comment on a study published in The Lancet Global Health by Audrey Pettifor and colleagues on cash transfers, school attendance and the reduction of HIV risk behaviours in adolescent girls.
Cash transfers have been proposed as an intervention to reduce HIV-infection risk for young women in sub-Saharan Africa. However, scarce evidence is available about their effect on reducing HIV acquisition. The authors aimed to assess the effect of a conditional cash transfer on HIV incidence among young women in rural South Africa. Based on their research findings, the authors draw the conclusion that cash transfers conditional on school attendance did not reduce HIV incidence in young women. School attendance significantly reduced risk of HIV acquisition, irrespective of study group. …
Lack of education and an economic dependence on men are often suggested as important risk factors for HIV infection in women. The authors assessed the efficacy of a cash transfer programme for schooling to reduce the risk of sexually transmitted infections in young women. Based on their findings the authors conclude that cash transfer programmes can reduce HIV and HSV-2 infections in adolescent schoolgirls in low-income settings. Structural interventions that do not directly target sexual behaviour change can be important components of HIV prevention strategies.
This discussion paper synthesizes the evidence for the effectiveness of cash transfers for HIV prevention and explores implications and opportunities for advancing research and policy agendas. Much of this evidence centres on girls and young women, who bear significant HIV burdens, particularly in sub-Saharan Africa, and often have less control over their sexual choices than do men. Many forms of transfers exist that may contribute to HIV prevention. …
Background: Effective and scalable HIV prevention for adolescents in sub-Saharan Africa is needed. Cash transfers can reduce HIV incidence through reducing risk behaviours. However, questions remain about their effectiveness within national poverty-alleviation programmes, and their effects on different behaviours in boys and girls. Methods: In this case-control study, we interviewed South African adolescents (aged 10–18 years) between 2009 and 2012. …
This toolkit is intended for MDB-watchers, women's groups, affected communities, MDBs and other donors, and all stakeholders interested in (a) gaining information that may benefit their projects, particularly those focusing on improving reproductive health and HIV/AIDS services in the poorest communities of the world; (b) building their capacity to persuade MDBs to promote gender equality in all their reproductive health and HIV/AIDS investments; and (c) contributing to increasing and improving MDB spending on reproductive health and HIV/AIDS. …
A large randomized trial in Malawi shows that schoolgirls whose families received monthly cash transfers had a significantly lower HIV infection rate than the control group. The two-year experiment in Zomba, a district in southern Malawi, offered cash to households with schoolgirls aged 13-22 who had never been married. Some of the offers were conditional on regular school attendance, while others were unconditional. Eighteen months after the program began, the HIV prevalence among program beneficiaries was 60% lower than the control group (1.2% vs. 3.0%). …
Recent evidence suggests that conditional cash transfer programs for schooling are effective in raising school enrollment and attendance. However, there is also reason to believe that such programs can affect other outcomes, such as the sexual behavior of their young beneficiaries. Zomba Cash Transfer Program is a randomized, ongoing conditional cash transfer intervention targeting young women in Malawi that provides incentives (in the form of school fees and cash transfers) to current schoolgirls and recent dropouts to stay in or return to school. …
This brief shows how three of the biggest donors to global HIV/AIDS programs can go beyond their stated commitments to address gender inequality and more effectively combat HIV and AIDS.
Although HIV can strike anyone, it is not an equal opportunity virus. Gender inequality, poverty, lack of education and inadequate access to comprehensive sexual and reproductive health services continue to fuel the epidemic. This booklet will detail how and why prevention works. By applying the principles of prevention to diverse populations around the world, the global community can help slow, and possibly halt, what is proving to be one of the greatest health challenges of our time. …
