Schooling, Income, and HIV Risk in Malawi (SIHR)

George Washington University (GW)

Status: Completed

Conditions: Unconditional Cash Transfers; HIV; Schooling; Conditional Cash Transfers

Treatments: Behavioral: Zomba Cash Transfer Program

Study type: Interventional

Funder types: Other

Identifiers

NCT01333826

RSB: RF-P109215-RESE-BBRSB (Other Grant/Funding Number)

KCP: RF-P109215-RESE-TF090932

Details and patient eligibility

About

This study is designed to evaluate a two-year randomized intervention in Malawi that provides cash transfers to current schoolgirls (and young women who have recently dropped out of school) to stay in (and return to) school in order to understand the possible effects of such programs on the sexual behavior of the beneficiaries and their subsequent HIV risk.

Full description

Motivation:

Education has been suggested as a "social vaccine" to prevent the spread of HIV (Jukes, Simmons, and Bundy, 2008), but almost all of the evidence we have on the link between school attendance (or attainment) and the risk of HIV infection comes from cross-sectional studies. Furthermore, the role of income (especially that of women's poverty) has been hypothesized as a significant factor in the spread of HIV in SSA, but again there is no credible evidence showing a causal link between income and HIV risk. A randomized intervention, such as the one proposed here, that provides randomly varied amounts of cash transfers to young individuals and their guardians is the perfect setting to examine the possible existence of such causal relationships.

Objectives:

The objective of the proposed study here is to provide credible evidence on issues about which we still know very little. Specifically, the main questions the study will try to answer are the following:

1. Are the observed effects of a CCT associated with the transfer or the conditionality imposed on the recipient?
2. Do the outcomes of interest improve with increased benefit levels set by the program?
3. Do CCT programs for schooling have any positive health impacts, including prevention of STIs such as HIV/AIDS among young people?

Enrollment: 3,796 patients

Sex: Female

Ages: 13 to 22 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

• female
• 13-22 years old
• never married

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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3,796 participants in 3 patient groups

Unconditional cash transfers

Experimental group

Description:

Monthly cash transfers given to households with school aged girls with no strings attached. Transfer amounts randomized within this arm.

Treatment:

Behavioral: Zomba Cash Transfer Program

Conditional Cash Transfer

Experimental group

Description:

Monthly cash transfers given to households with school aged girls conditional on regular school attendance (80%). Transfer amounts randomized within this arm.

Treatment:

Behavioral: Zomba Cash Transfer Program

Control Group

No Intervention group

Description:

No cash transfer program implemented in this group.