Evaluating Conditional Cash Transfers to Prevent HIV and Other Sexually Transmitted Infections (STIs) in Tanzania

William H. Dow, University of California, Berkeley
Rose Nathan, Ifakara Health Institute (IHI)
Carol Medlin, Bill & Melinda Gates Foundation

This study evaluates a randomized intervention that uses economic incentives to reduce risky sexual behavior among people aged 18-30 and their spouses in rural Tanzania. The goal is to prevent HIV, other sexually transmitted infections (STIs), and unintended pregnancy by linking cash rewards to negative STI test results assessed every 4 months. The study tests the hypothesis that a system of rapid feedback and positive reinforcement using cash as a primary incentive to reduce risky sexual behavior, coupled with individual and group counseling, can be used to promote safer sexual activity among young people who are at high risk of HIV infection. This paper reports initial results of the randomized controlled trial, finding that enrollees offered $20 incentives experienced 25% lower STI prevalence than the control group enrollees after one year.