A Randomized Control Trial of a Conditional Cash Transfer to Reduce HIV Infection in Young Women in South Africa: Study Design and Baseline Results
This individually randomized controlled trial was the first study to examine the impact of a conditional cash transfer intervention on HIV infection among young women. In a rural area in northeastern South Africa, 2,533 women (age 13–20 years) and their households were randomized in a 1:1 ratio to the intervention arm (monthly cash payments, conditional on the young woman completing 80 percent school attendance), or the control arm (no cash payments). HIV testing was performed at enrollment and at 12-, 24-, and 36-month visits. Findings showed that despite a low HIV prevalence at baseline, a number of individual, partner, household, and school-level factors were associated with HIV and herpes simplex virus type 2 infection. Over one-third (34.3%) of girls reported worrying about having enough to eat during the past 12 months. After adjusting for age, the authors found that factors at all levels were associated with significantly increased odds of HIV infection; partner-level factors had the strongest association. One-fifth of participants reported having a partner five or more years older, and 14 percent reported engaging in transactional sex. The authors concluded that interventions like cash transfers, which address structural factors such as poverty, have the potential to reduce HIV risk in young women in South Africa.