Effect of a Cash Transfer Programme for Schooling on Prevalence of HIV and Herpes Simplex Type 2 in Malawi: A Cluster Randomised Trial
Baird, S.J., Garfein, R.S, McIntosh, C.T., et al. The Lancet (April 2012), 379 (9823): pp. 1320–1329, doi: 10.1016/S0140-6736(11)61709-1.
According to the findings of this randomized controlled trial in Malawi, girls and young women ages 13–22 who receive regular small cash payments are less than half as likely to acquire HIV than their counterparts who receive no cash payment. The study recruited approximately 1,300 never-married young women living in an area with high poverty, low school enrollment, and high HIV prevalence. The young women and their families were randomized to receive small monthly stipends for 18 months: between US$1 and $5 for the girls and US$4 and $10 for the families (conditional on school attendance or unconditional), or nothing at all. Girls who received payments were 75 percent less likely to acquire herpes simplex virus 2 (HSV-2). They were also more likely to attend school, less likely to have sex regularly and a partner older than 25 years. The authors did not detect a difference in age at sexual debut or condom use, and found no notable difference in HIV or HSV-2 prevalence between the conditional and unconditional cash transfer groups. They concluded that simple cash transfer programs for unmarried schoolgirls and their families may have a significant effect on girls’ sexual and reproductive health, and encouraged policymakers to consider such programs as a component of combination prevention approaches.