Effects of Cash Transfer for the Prevention of HIV in Young South African Women

Cash transfers to young women for staying in school and its effect on acquiring HIV

Study Overview

• Status: Completed
• Conditions: HIV
• Intervention / Treatment: Behavioral: monthly cash transfer payments for attending school; Behavioral: B--No cash transfers

Detailed Description

The overall purpose of this study is to determine whether providing cash transfers to young women and their household, conditional on school attendance, reduces young women's risk of acquiring Human Immunodeficiency Virus (HIV). The overall goal of the Conditional Cash Transfer (CCT) intervention is to reduce structural barriers to education with the goal of increasing school attendance of young women, thereby decreasing their HIV risk.

• Study Type: Interventional
• Enrollment (Actual): 2537
• Phase: Phase 3

Contacts and Locations

Study Locations

• South Africa
  • Acornhoek, South Africa
    • Agincourt

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 13 years to 20 years (Child, Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

• Female aged 13 to 20 years.
• Enrolled in grades 8, 9, 10 or 11 at the beginning of the study at schools in the AHDSS study site
• Intending to continue to live in the study site until the end of the follow-up period.
• Be willing and able to consent/assent to all study procedures including HIV and HSV-2 testing.
• Able to read sufficiently to use ACASI.
• Have a bank or post office account or have documentation to be able to open a bank or post office account (i.e., birth certificate, South African National Identification Book, or passport and proof of residence). Post Office accounts will only be required for participants in the Intervention arm.
• Parent/Legal Guardian who lives with young woman, willing and able to consent to all study procedures including HIV and HSV-2 testing.
• Parent/Legal Guardian has a bank or post office account or has documentation to be able to open a bank or post office account (i.e. South African National Identification Book, or passport and proof of residence). Note that the account may be opened in the name of any adult who resides in the household with the young woman.

Exclusion Criteria:

• Pregnant by self-report at baseline.
• Married at baseline.
• No parent or legal guardian living in household.
• Any other reason that the staff feels would jeopardize the health or well-being of the participant or staff or would prevent proper conduct of the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: A--Monthly cash transfers; Monthly cash transfer payments	Behavioral: monthly cash transfer payments for attending school; In the intervention, young women and their households will be randomized in 1:1 ratio to receive monthly cash transfer payments, conditional on the young woman attending school, or to the control arm. Young women will be recruited at the beginning of grades 8 through 11 in the first year of the study.
Other: B--No cash transfers; No cash transfers.	Behavioral: monthly cash transfer payments for attending school; In the intervention, young women and their households will be randomized in 1:1 ratio to receive monthly cash transfer payments, conditional on the young woman attending school, or to the control arm. Young women will be recruited at the beginning of grades 8 through 11 in the first year of the study.; Behavioral: B--No cash transfers; No monthly cash transfers

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
HIV Incidence	To determine whether young women who are randomized to receive CCTs conditional on school attendance have a lower incidence of HIV infection over time compared to young women who are not randomized to receive cash transfers.	4 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
HSV-2 incidence	To determine whether young women who are randomized to receive CCTs conditional on school attendance have a lower incidence of Herpes Simplex Virus type 2 (HSV-2) infections over time compared to young women who are not randomized to receive cash transfers.	4 years
HSV Incidence	To determine whether young women who receive the CCTs report less unprotected sex, fewer number of sexual partners, younger male partners, an older age of coital debut, a lower incidence of self-reported pregnancy, and greater school attendance compared to young women who do not receive the cash transfers.	4 years

Collaborators and Investigators

• Sponsor: HIV Prevention Trials Network
• Collaborators: National Institute of Allergy and Infectious Diseases (NIAID); National Institute of Mental Health (NIMH); National Institutes of Health (NIH)
• Investigators: Study Chair: Audrey Pettifor, University of North Carolina; Principal Investigator: Xavier Gomez-Olive, Wits Rural Public Health and Health Transitions Research Unit; Principal Investigator: Kathleen Kahn, University of Witwatersrand, South Africa; Principal Investigator: Catherine McPhail, Reproductive Health & HIV Research Unit, University of Witwatersrand

Publications and helpful links

General Publications

• Jayaweera RT, Goin D, Twine R, Neilands TB, Wagner RG, Lippman SA, Kahn K, Pettifor A, Ahern J. Associations between WASH-related violence and depressive symptoms in adolescent girls and young women in South Africa (HPTN 068): a cross-sectional analysis. BMJ Open. 2022 Jul 5;12(7):e061032. doi: 10.1136/bmjopen-2022-061032.
• DeLong SM, Powers KA, Pence BW, Maman S, Dunkle KL, Selin A, Twine R, Wagner RG, Gomez-Olive FX, MacPhail C, Kahn K, Pettifor A. Longitudinal Trajectories of Physical Intimate Partner Violence Among Adolescent Girls in Rural South Africa: Findings From HPTN 068. J Adolesc Health. 2020 Jul;67(1):69-75. doi: 10.1016/j.jadohealth.2019.12.016. Epub 2020 Feb 13.
• MacPhail C, Khoza N, Selin A, Julien A, Twine R, Wagner RG, Gomez-Olive X, Kahn K, Wang J, Pettifor A. Cash transfers for HIV prevention: what do young women spend it on? Mixed methods findings from HPTN 068. BMC Public Health. 2017 Jul 11;18(1):10. doi: 10.1186/s12889-017-4513-3. Erratum In: BMC Public Health. 2017 Sep 22;17 (1):736.
• Pettifor A, MacPhail C, Hughes JP, Selin A, Wang J, Gomez-Olive FX, Eshleman SH, Wagner RG, Mabuza W, Khoza N, Suchindran C, Mokoena I, Twine R, Andrew P, Townley E, Laeyendecker O, Agyei Y, Tollman S, Kahn K. The effect of a conditional cash transfer on HIV incidence in young women in rural South Africa (HPTN 068): a phase 3, randomised controlled trial. Lancet Glob Health. 2016 Dec;4(12):e978-e988. doi: 10.1016/S2214-109X(16)30253-4. Epub 2016 Nov 1. Erratum In: Lancet Glob Health. 2017 Feb;5(2):e146.

Study record dates

Study Major Dates

• Study Start: March 1, 2011
• Primary Completion (Actual): March 1, 2015
• Study Completion (Actual): March 1, 2015

Study Registration Dates

• First Submitted: November 1, 2010
• First Submitted That Met QC Criteria: November 2, 2010
• First Posted (Estimate): November 3, 2010

Study Record Updates

• Last Update Posted (Actual): August 26, 2022
• Last Update Submitted That Met QC Criteria: August 25, 2022
• Last Verified: August 1, 2022

More Information

Terms related to this study

• Other Study ID Numbers: HPTN 068; UM1AI068619 (U.S. NIH Grant/Contract); 11710 (Other Identifier: DAIDS ID: 11710)