Coping with Risk: Negative Shocks, Transactional Sex, and the Limitations of Conditional Cash Transfers
Publication date: Available online 3 August 2019Source: Journal of Health EconomicsAuthor(s): Erick Gong, Damien de Walque, William H. DowAbstractTransactional sex is an important risk-coping mechanism and a leading contributor to the HIV/AIDS epidemic in sub-Saharan Africa. We use data from a conditional cash transfer (CCT) experiment in rural Tanzania designed to incentivize safer sexual behavior by conditioning transfers on testing negative for sexually transmitted infections (STIs). For women, we find that negative shocks measured by food insecurity lead to a 36% increase in STIs and increases in self-reported risky sexual behavior. We find no significant effects of negative shocks on either STIs or self-reported sexual behavior for men. This CCT design did not appear to mitigate the behavioral response to shocks that we document in women. We propose that this finding can be explained by binding credit constraints and the relatively infrequent timing of the CCTs. When women experience a negative shock, cash needs are immediate, while transfers linked to a CCT are paid out in a specific point in time. If women are unable to access credit during a shock, they may resort to transactional sex even if they face monetary incentives to do otherwise.
CONCLUSIONS: Strategies mobilizing MSM for targeted AEHI testing resulted in substantially higher AEHI yields than universal AEHI testing. Targeted AEHI testing may be optimized using risk and/or symptom scores, especially if scores include symptoms. Studies assessing AEHI yield and validation of risk and/or symptom scores among MSM in SSA are urgently needed. PMID: 33000916 [PubMed - in process]
CONCLUSIONS: Prevalence and incidence of urethral and rectal STIs were high among these South African MSM and TGW, and were similar to rates in other settings in the world. Clinical symptoms from these infections were rare, highlighting limitations of syndromic surveillance and suggesting the need for presumptive testing and/or treatment to address the STI epidemic among MSM/TGW in South Africa. PMID: 33000886 [PubMed - in process]
In response to growing evidence of an expanding epidemic of sexually acquired hepatitis C virus (HCV) infection in HIV-positive MSM, the European AIDS Treatment Network (NEAT) acute hepatitis C consensus panel developed their first recommendations for HCV prevention and care during a consensus conference in May 2010 in Paris, France. As then, two major breakthroughs have changed the landscape. First, directly acting antivirals (DAA) with high levels of tolerability and HCV cure rates of over 95% are now widely available and will play a large role in the goal of elimination of HCV by 2030 (WHO sector strategy). Second, land...
Conclusion Crowdsourced posters were of higher craftsmanship, possibly due to their ability to recruit skills of professional designers. The CDC posters' use of positive visual reinforcement (smiling faces) and educational messaging may be a legacy of their role in the early days of the epidemic in disseminating basic HIV/AIDS knowledge and dispelling misinformation. Crowdsourcing posters' used more metaphors, suggesting better ability to leverage in-group codes and language.
[Ghanaian Times] Until the outbreak of the coronavirus pandemic late last year, HIV/AIDS was regarded as the world's worst epidemic humanity had ever faced.
[The Conversation Africa] South Africa is home to the world's largest epidemic of HIV, a virus that attacks a person's immune system, making one more susceptible to other infections. Sustained treatment with effective antiretroviral therapy (ART) can enable people living with HIV to achieve near-normal life expectancy. But, according to 2019 figures, only two thirds of an estimated 7.7 million people living with HIV in South Africa were on ART.
[GFO] On 24 April 2020, the Global Fund, the World Health Organization (WHO) and a range of global health actors launched the Access to COVID-19 Tools (ACT) Accelerator, a global collaboration to speed up the development and production of vaccines, diagnostics, and therapeutics for the coronavirus disease 2019 (COVID-19) for all who need them globally. The other global health actors in the partnership include the Bill&Melinda Gates Foundation (BMGF), the Coalition for Epidemic Preparedness Innovations (CEP
[Daily News] ZANZIBAR has the lowest HIV epidemic in sub-Sahara Africa with prevalence rate at below 0.4 per cent, according to Zanzibar Aids Commission (ZAC) data but a rising number of people belonging to the vulnerable group and key population is posing new challenges.
[Daily Maverick] There are lessons to be learnt from those who have witnessed not one, but two epidemics: the HIV/AIDS epidemic and the most recent Covid-19 pandemic--but we must harness the power of society.
Conclusion: Such rising trends of attendees and a steady decline in the seropositivity rates are encouraging signs, reflecting the contribution of the ICTC in creating awareness, and reducing the transmission of HIV among the population served.