XIX International AIDS Conference

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FRLBD01 - Oral Abstract Session


Effect of a national social cash transfer program on HIV risk behavior in Kenya

Presented by Sudhanshu Handa (United States).

S. Handa1, A. Pettifor2, H. Thirumurthy3, C. Halpern4


1University of North Carolina - Chapel Hill, Public Policy and Carolina Population Center, Chapel Hill, United States, 2University of North Carolina - Chapel Hill, Epidemiology, Chapel Hill, United States, 3University of North Carolina - Chapel Hill, Health Policy and Management, Chapel Hill, United States, 4University of North Carolina - Chapel Hill, Maternal and Child Health, Chapel Hill, United States

Background: : Cash transfer programs may reduce the risk of HIV transmission among young people from poor households by providing economic security. The Cash Transfer for Orphans and Vulnerable Children (CT-OVC) is the Government of Kenya's flagship social protection program, reaching 150,000 poor families with OVC age 17 or below. Households are provided a flat unconditional cash transfer of US$25 per month. The objective of this study is to assess whether the CT-OVC reduces HIV related behavioral risk among adolescents.
Methods: We use data from the third wave of the impact evaluation of the CT-OVC collected in 2011. The design is a cluster-randomized trial. 1912 households in seven districts across Kenya were part of wave three; two-thirds were in the program and the remaining third were randomized out at baseline in 2007. Data on sexual behavior and other risk related behaviors were collected in wave 3 only for residents age 15-25. We analyze data for residents age 21 and below who had not had sexual intercourse at baseline (N=1516, Females=41%). We use multivariate analysis with controls for age, sex, Nairobi residence, and relationship to household head.
Results: Main study findings indicate that the CT-OVC has reduced the probability of sexual debut by 6.73 percentage points off a proportion of 0.37 who had ever had sex after the program began in 2007. This result appears to be driven by males. The program has also reduced the proportion of adolescents with 2 or more partners in the last 12 months, by 7.2 percentage points , and reduced the probability of 2 or more unprotected sex acts in the last 3 months for females (p=0.10).

 Had sex?Age at first sexForced at first sexCondom used at first sexFirst partner 10+ years older2+ partners last 12 months2+ unprotected sex acts last 3 months
Impact-0.0673**0.121-0.0179-0.0129-0.00978-0.0723**-0.100
N1,516611594609583430115
Sample is individuals who had not had sex at baseline in 2007. OLS regressions controlling age, sex, Nairobi, child and grandchild of head. All regressions are linear probability models except for 'age at first sex'. 'Impact' coefficient indicates difference between intervention and control group. Statistically significant coefficients (P<.10) denoted by **.
        
[Table 1: Main Results Age<=21]


Conclusions: A large scale, national cash transfer program may prevent HIV among adolescents by postponing sexual debut, reducing the number of partners and reducing the number of unprotected sex acts.


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