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Do Gifts Increase Consent to Home-based HIV Testing? A Difference-in-Differences Study in Rural KwaZulu-Natal, South Africa

Author

Listed:
  • Mark E. McGovern
  • Kobus Herbst
  • Frank Tanser
  • Tinofa Mutevedzi
  • David Canning
  • Dickman Gareta
  • Deenan Pillay
  • Till Bärnighausen

Abstract

Despite the importance of HIV testing for controlling the HIV epidemic, testing rates remain low. Efforts to scale up testing coverage and frequency in hard-to-reach and at-risk populations commonly focus on home-based HIV testing. This study evaluates the effect of a gift (a US $5 food voucher for families) on consent rates for home-based HIV testing. We use data on 18,478 individuals (6,418 men and 12,060 women) who were successfully contacted to participate in the 2009 and 2010 population-based HIV surveillance carried out by the Wellcome Trust's Africa Health Research Institute in rural KwaZulu-Natal, South Africa. Of 18,478 potential participants contacted in both years, 35% (6,518) consented to test in 2009, and 41% (7,533) consented to test in 2010. Our quasi-experimental difference-in-differences approach controls for unobserved confounding in estimating the causal effect of the intervention on HIV-testing consent rates. Allocation of the gift to a family in 2010 increased the probability of family members consenting to test in the same year by 25 percentage points [95% confidence interval (CI) 21--30 percentage points; P less than 0.001]. The intervention effect persisted, slightly attenuated, in the year following the intervention (2011). In HIV hyperendemic settings, a gift can be highly effective at increasing consent rates for home-based HIV testing. Given the importance of HIV testing for treatment uptake and individual health, as well as for HIV treatment-as-prevention strategies and for monitoring the population impact of the HIV response, gifts should be considered as a supportive intervention for HIV-testing initiatives where consent rates have been low.

Suggested Citation

  • Mark E. McGovern & Kobus Herbst & Frank Tanser & Tinofa Mutevedzi & David Canning & Dickman Gareta & Deenan Pillay & Till Bärnighausen, 2016. "Do Gifts Increase Consent to Home-based HIV Testing? A Difference-in-Differences Study in Rural KwaZulu-Natal, South Africa," CHaRMS Working Papers 16-05, Centre for HeAlth Research at the Management School (CHaRMS).
    • Handle: RePEc:qub:charms:1605
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    1. Uri Gneezy & Stephan Meier & Pedro Rey-Biel, 2011. "When and Why Incentives (Don't) Work to Modify Behavior," Journal of Economic Perspectives, American Economic Association, vol. 25(4), pages 191-210, Fall.
    2. Hans-Peter Kohler & Rebecca L. Thornton, 2012. "Conditional Cash Transfers and HIV/AIDS Prevention: Unconditionally Promising?," The World Bank Economic Review, World Bank, vol. 26(2), pages 165-190.
    3. McGovern, Mark E. & Bärnighausen, Till & Giampiero Marra & Rosalba Radice, 2015. "On the Assumption of Bivariate Normality in Selection Models: A Copula Approach Applied to Estimating HIV Prevalence," Working Paper 199101, Harvard University OpenScholar.
    4. Kalpana Sabapathy & Rafael Van den Bergh & Sarah Fidler & Richard Hayes & Nathan Ford, 2012. "Uptake of Home-Based Voluntary HIV Testing in Sub-Saharan Africa: A Systematic Review and Meta-Analysis," PLOS Medicine, Public Library of Science, vol. 9(12), pages 1-14, December.
    5. Posner, Richard A, 1980. "A Theory of Primitive Society, with Special Reference to Law," Journal of Law and Economics, University of Chicago Press, vol. 23(1), pages 1-53, April.
    6. Susan Athey & Guido W. Imbens, 2006. "Identification and Inference in Nonlinear Difference-in-Differences Models," Econometrica, Econometric Society, vol. 74(2), pages 431-497, March.
    7. William Greene, 2004. "The behaviour of the maximum likelihood estimator of limited dependent variable models in the presence of fixed effects," Econometrics Journal, Royal Economic Society, vol. 7(1), pages 98-119, June.
    8. Richard Blundell & Monica Costa Dias & Costas Meghir & John Van Reenen, 2004. "Evaluating the Employment Impact of a Mandatory Job Search Program," Journal of the European Economic Association, MIT Press, vol. 2(4), pages 569-606, June.
    9. Mark Gersovitz, 2011. "HIV Testing: Principles and Practice," The World Bank Research Observer, World Bank, vol. 26(1), pages 1-41, February.
    10. Sarah Baird & Craig McIntosh & Berk Özler, 2011. "Cash or Condition? Evidence from a Cash Transfer Experiment," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 126(4), pages 1709-1753.
    11. Brock, J. Michelle & Lange, Andreas & Leonard, Kenneth L., 2018. "Giving and promising gifts: Experimental evidence on reciprocity from the field," Journal of Health Economics, Elsevier, vol. 58(C), pages 188-201.
    12. Joseph Larmarange & Joël Mossong & Till Bärnighausen & Marie Louise Newell, 2015. "Participation Dynamics in Population-Based Longitudinal HIV Surveillance in Rural South Africa," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-16, April.
    13. Wendy Janssens & Jacques Gaag & Tobias Rinke de Wit & Zlata Tanović, 2014. "Refusal Bias in the Estimation of HIV Prevalence," Demography, Springer;Population Association of America (PAA), vol. 51(3), pages 1131-1157, June.
    14. de Walque, Damien & Dow, William H & Nathan, Rose & Abdul, Ramadhani & Abilahi, Faraji & Gong, Erick & Isdahl, Zachary & Jamison, Julian & Jullu, Boniphace & Krishnan, Suneeta & Majura, Albert & Migue, 2012. "Incentivising safe sex: a randomised trial of conditional cash transfers for HIV and sexually transmitted infection prevention in rural Tanzania," Department of Economics, Working Paper Series qt4vw984q0, Department of Economics, Institute for Business and Economic Research, UC Berkeley.
    15. Rebecca L. Thornton, 2008. "The Demand for, and Impact of, Learning HIV Status," American Economic Review, American Economic Association, vol. 98(5), pages 1829-1863, December.
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    Cited by:

    1. McGovern, Mark E. & Rokicki, Slawa & Reichman, Nancy E., 2022. "Maternal depression and economic well-being: A quasi-experimental approach," Social Science & Medicine, Elsevier, vol. 305(C).
    2. Slawa Rokicki & Jessica Cohen & Gunther Fink & Joshua Salomon & Mary Beth Landrum, 2018. "Inference with difference-in-differences with a small number of groups: a review, simulation study and empirical application using SHARE data," CHaRMS Working Papers 18-01, Centre for HeAlth Research at the Management School (CHaRMS).
    3. McGovern, Mark E. & Canning, David & Bärnighausen, Till, 2018. "Accounting for non-response bias using participation incentives and survey design: An application using gift vouchers," Economics Letters, Elsevier, vol. 171(C), pages 239-244.
    4. Declan French & Jonathan Brink & Till Bärnighausen, 2019. "Early HIV treatment and labour outcomes: A case study of mining workers in South Africa," Health Economics, John Wiley & Sons, Ltd., vol. 28(2), pages 204-218, February.
    5. Mark McGovern & David Canning & Till Bärnighausen, 2018. "Accounting for Non-Response Bias using Participation Incentives and Survey Design," CHaRMS Working Papers 18-02, Centre for HeAlth Research at the Management School (CHaRMS).
    6. Tshifhiwa Muravha & Christopher J Hoffmann & Claire Botha & Wellington Maruma & Salome Charalambous & Candice M Chetty-Makkan, 2021. "Exploring perceptions of low risk behaviour and drivers to test for HIV among South African youth," PLOS ONE, Public Library of Science, vol. 16(1), pages 1-15, January.

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    More about this item

    Keywords

    Gift-voucher Intervention; Incentives; Difference-in-Differences; Home-based HIV Testing; South Africa;
    All these keywords.

    JEL classification:

    • J10 - Labor and Demographic Economics - - Demographic Economics - - - General
    • I10 - Health, Education, and Welfare - - Health - - - General

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