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Conditional Cash Transfers and HIV/AIDS Prevention: Unconditionally Promising?

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  • Hans-Peter Kohler
  • Rebecca L. Thornton

Abstract

Conditional cash transfers (CCTs) have recently received considerable attention as a potentially innovative and effective approach to the prevention of HIV/AIDS. We evaluate a conditional cash transfer program in rural Malawi which offered financial incentives to men and women to maintain their HIV status for approximately one year. The amounts of the reward ranged from zero to approximately 3–4 months wage. We find no effect of the offered incentives on HIV status or on reported sexual behavior. However, shortly after receiving the reward, men who received the cash transfer were 9 percentage points more likely and women were 6.7 percentage points less likely to engage in risky sex. Our analyses therefore question the “unconditional effectiveness” of CCT program for HIV prevention: CCT Programs that aim to motivate safe sexual behavior in Africa should take into account that money given in the present may have much stronger effects than rewards offered in the future, and any effect of these programs may be fairly sensitive to the specific design of the program, the local and/or cultural context, and the degree of agency an individual has with respect to sexual behaviors. Copyright 2012, Oxford University Press.

Suggested Citation

  • Hans-Peter Kohler & Rebecca L. Thornton, 2012. "Conditional Cash Transfers and HIV/AIDS Prevention: Unconditionally Promising?," World Bank Economic Review, World Bank Group, vol. 26(2), pages 165-190.
  • Handle: RePEc:oup:wbecrv:v:26:y:2012:i:2:p:165-190
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    File URL: http://hdl.handle.net/10.1093/wber/lhr041
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    References listed on IDEAS

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    1. Oster, Emily, 2012. "HIV and sexual behavior change: Why not Africa?," Journal of Health Economics, Elsevier, vol. 31(1), pages 35-49.
    2. Maluccio, John A. & Flores, Rafael, 2005. "Impact evaluation of a conditional cash transfer program: the Nicaraguan Red de Protección Social," Research reports 141, International Food Policy Research Institute (IFPRI).
    3. Xavier Giné & Dean Karlan & Jonathan Zinman, 2010. "Put Your Money Where Your Butt Is: A Commitment Contract for Smoking Cessation," American Economic Journal: Applied Economics, American Economic Association, vol. 2(4), pages 213-235, October.
    4. Sarah Baird & Ephraim Chirwa & Craig McIntosh & Berk Özler, 2010. "The short‐term impacts of a schooling conditional cash transfer program on the sexual behavior of young women," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 55-68, September.
    5. Paul Gertler & Manisha Shah & Stefano M. Bertozzi, 2005. "Risky Business: The Market for Unprotected Commercial Sex," Journal of Political Economy, University of Chicago Press, vol. 113(3), pages 518-550, June.
    6. Ariel Fiszbein & Norbert Schady & Francisco H.G. Ferreira & Margaret Grosh & Niall Keleher & Pedro Olinto & Emmanuel Skoufias, 2009. "Conditional Cash Transfers : Reducing Present and Future Poverty," World Bank Publications, The World Bank, number 2597.
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    Cited by:

    1. Kathleen Beegle & Michelle Poulin & Gil Shapira, 2015. "HIV Testing, Behavior Change, and the Transition to Adulthood in Malawi," Economic Development and Cultural Change, University of Chicago Press, vol. 63(4), pages 665-684.
    2. Jan Ostermann & Derek Brown & Axel Mühlbacher & Bernard Njau & Nathan Thielman, 2015. "Would you test for 5000 Shillings? HIV risk and willingness to accept HIV testing in Tanzania," Health Economics Review, Springer, vol. 5(1), pages 1-11, December.
    3. Marshall Burke & Erick Gong & Kelly Jones, 2015. "Income Shocks and HIV in Africa," Economic Journal, Royal Economic Society, vol. 125(585), pages 1157-1189, June.
    4. Datta, Saugato & Burns, Justine & Maughan-Brown, Brendan & Darling, Matthew & Eyal, Katherine, 2015. "Risking it all for love? Resetting beliefs about HIV risk among low-income South African teens," Journal of Economic Behavior & Organization, Elsevier, vol. 118(C), pages 184-198.
    5. Björkman Nyqvist, Martina & Corno, Lucia & de Walque, Damien & Svensson, Jakob, 2016. "Incentivizing Safer Sexual Behavior: Evidence from a Lottery Experiment on HIV Prevention," CEPR Discussion Papers 11542, C.E.P.R. Discussion Papers.
    6. Wilson, Nicholas, 2012. "Economic booms and risky sexual behavior: Evidence from Zambian copper mining cities," Journal of Health Economics, Elsevier, vol. 31(6), pages 797-812.
    7. TENIKUE Michel & TEQUAME Miron, 2018. "Economic and Health Impacts of the 2011 Post-Electoral Crisis in Côte d?Ivoire: Evidence from Microdata," LISER Working Paper Series 2018-03, LISER.
    8. Nicholas Wilson, 2010. "Economic Growth and the HIV/AIDS Pandemic: Evidence from the Early 21st Century Copper Boom," Center for Development Economics 2011-04, Department of Economics, Williams College.
    9. Black, Samantha & Wallace, Melissa & Middelkoop, Keren & Robbertze, Dante & Bennie, Thola & Wood, Robin & Bekker, Linda-Gail, 2014. "Improving HIV testing amongst adolescents through an integrated Youth Centre rewards program: Insights from South Africa," Children and Youth Services Review, Elsevier, vol. 45(C), pages 98-105.
    10. repec:kap:theord:v:83:y:2017:i:4:d:10.1007_s11238-017-9625-9 is not listed on IDEAS
    11. Burke, Marshall & Gong, Erick & Jones, Kelly, 2011. "Income shocks and HIV in Sub-Saharan Africa:," IFPRI discussion papers 1146, International Food Policy Research Institute (IFPRI).
    12. Ryota Nakamura & Marc Suhrcke & Daniel John Zizzo, 2017. "A triple test for behavioral economics models and public health policy," Theory and Decision, Springer, vol. 83(4), pages 513-533, December.
    13. Poulin, Michelle & Dovel, Kathryn & Watkins, Susan Cotts, 2016. "Men with Money and the “Vulnerable Women” Client Category in an AIDS Epidemic," World Development, Elsevier, vol. 85(C), pages 16-30.

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