Stimulating Demand for AIDS Prevention : Lessons from the RESPECT Trial

de Walque, Damien; Dow, William H.; Medlin, Carol; Nathan, Rose

dc.creator	de Walque, Damien
dc.creator	Dow, William H.
dc.creator	Medlin, Carol
dc.creator	Nathan, Rose
dc.date	2012-03-19T17:29:16Z
dc.date	2012-03-19T17:29:16Z
dc.date	2012-02-01
dc.date.accessioned	2023-02-17T20:50:05Z
dc.date.available	2023-02-17T20:50:05Z
dc.identifier	http://www-wds.worldbank.org/external/default/main?menuPK=64187510&pagePK=64193027&piPK=64187937&theSitePK=523679&menuPK=64187510&searchMenuPK=64187283&siteName=WDS&entityID=000158349_20120221132307
dc.identifier	http://hdl.handle.net/10986/3259
dc.identifier.uri	http://localhost:8080/xmlui/handle/CUHPOERS/243694
dc.description	HIV-prevention strategies have yielded only limited success so far in slowing down the AIDS epidemic. This paper examines novel intervention strategies that use incentives to discourage risky sexual behaviors. Widely-adopted conditional cash transfer programs that offer payments conditioning on easily monitored behaviors, such as well-child health care visits, have shown positive impact on health outcomes. Similarly, contingency management approaches have successfully used outcome-based rewards to encourage behaviors that are not easily monitored, such as stopping drug abuse. These strategies have not been used in the sexual domain, so this paper assesses how incentives can be used to reduce risky sexual behavior. After discussing theoretical pathways, it discusses the use of sexual-behavior incentives in the Tanzanian RESPECT trial. There, participants who tested negative for sexually transmitted infections are eligible for outcome-based cash rewards. The trial was well-received in the communities, with high enrollment rates and more than 90 percent of participants viewing the incentives favorably. After one year, 57 percent of enrollees in the "low-value" reward arm stated that the cash rewards "very much" motivated sexual behavioral change, rising to 79 percent in the "high-value" reward arm. Despite its controversial nature, the authors argue for further testing of such incentive-based approaches to encouraging reductions in risky sexual behavior.
dc.language	English
dc.relation	Paper is funded by the Knowledge for Change Program (KCP),Policy Research working paper ; no. WPS 5973
dc.rights	CC BY 3.0 IGO
dc.rights	http://creativecommons.org/licenses/by/3.0/igo/
dc.rights	World Bank
dc.subject	ABSTINENCE
dc.subject	ADDICTION
dc.subject	ADDICTIVE BEHAVIORS
dc.subject	ADOLESCENT
dc.subject	ADOLESCENT GIRL
dc.subject	ADULT PREVALENCE
dc.subject	ADULT PREVALENCE RATE
dc.subject	AGED
dc.subject	AIDS EPIDEMIC
dc.subject	AIDS PANDEMIC
dc.subject	AIDS PATIENT
dc.subject	AIDS PREVENTION
dc.subject	AIDS VACCINE
dc.subject	ALCOHOL
dc.subject	ALCOHOL ABUSE
dc.subject	ALCOHOL DEPENDENCE
dc.subject	ALCOHOL USE
dc.subject	ANAL SEX
dc.subject	ANTENATAL CARE
dc.subject	ANTIVIRALS
dc.subject	BEHAVIOR CHANGE
dc.subject	BEHAVIORAL CHANGE
dc.subject	BEHAVIORAL CHANGES
dc.subject	BLOOD PRESSURE
dc.subject	BLOOD TESTS
dc.subject	BS
dc.subject	CHILD CARE
dc.subject	CHILD HEALTH
dc.subject	CHILD HEALTH CARE
dc.subject	CHLAMYDIA
dc.subject	CIRCUMCISION
dc.subject	CLINICAL PSYCHOLOGY
dc.subject	CLINICAL TRIALS
dc.subject	CLINICS
dc.subject	COCAINE
dc.subject	COMMERCIAL SEX
dc.subject	COMPLICATIONS
dc.subject	CONDOM
dc.subject	CONDOM PROMOTION
dc.subject	CONDOM USE
dc.subject	CONDOMS
dc.subject	CONTRACEPTION
dc.subject	CONTRACEPTIVE PREVALENCE
dc.subject	COST EFFECTIVENESS
dc.subject	COUNSELING INTERVENTION
dc.subject	DEVELOPING COUNTRIES
dc.subject	DEVELOPMENT POLICY
dc.subject	DEVELOPMENTAL PSYCHOLOGY
dc.subject	DIAGNOSIS
dc.subject	DISEASE
dc.subject	DISEASE CONTROL
dc.subject	DISEASE TRANSMISSION
dc.subject	DRUG ABUSE
dc.subject	DRUG USE
dc.subject	DRUGS
dc.subject	EARLY YEARS
dc.subject	EDUCATIONAL SERVICES
dc.subject	ETHICAL CONSIDERATIONS
dc.subject	FAMILIES
dc.subject	FAMILY PLANNING
dc.subject	FEMALES
dc.subject	FINANCIAL CONSTRAINTS
dc.subject	FOCUS GROUP DISCUSSIONS
dc.subject	GLOBAL AIDS EPIDEMIC
dc.subject	GLOBAL HEALTH
dc.subject	GONORRHEA
dc.subject	HEALTH CARE
dc.subject	HEALTH CARE SERVICES
dc.subject	HEALTH CONSEQUENCES
dc.subject	HEALTH EDUCATION
dc.subject	HEALTH IMPACT
dc.subject	HEALTH INTERVENTIONS
dc.subject	HEALTH OUTCOMES
dc.subject	HEALTH SERVICES
dc.subject	HEALTH SYSTEMS
dc.subject	HIGH RISK GROUPS
dc.subject	HIV
dc.subject	HIV INFECTIONS
dc.subject	HIV POSITIVE
dc.subject	HIV PREVENTION
dc.subject	HIV TESTING
dc.subject	HIV TRANSMISSION
dc.subject	HIV/AIDS
dc.subject	HUMAN CAPITAL
dc.subject	HUMAN DEVELOPMENT
dc.subject	ILLNESS
dc.subject	IMMUNIZATION
dc.subject	IMPACT ON HEALTH
dc.subject	INFECTION
dc.subject	INFECTION PREVENTION
dc.subject	INFORMED CONSENT
dc.subject	INTERNATIONAL FAMILY PLANNING
dc.subject	INTERNATIONAL FAMILY PLANNING PERSPECTIVES
dc.subject	INTERVENTION
dc.subject	JOURNAL OF MEDICINE
dc.subject	LACK OF INFORMATION
dc.subject	LOW PREVALENCE
dc.subject	MALE CIRCUMCISION
dc.subject	MALE SEX
dc.subject	MALE SEX WORKERS
dc.subject	MASS COMMUNICATION
dc.subject	MEDICAL RESEARCH
dc.subject	MEDICATION
dc.subject	MEDICINES
dc.subject	METHADONE
dc.subject	METHADONE PATIENTS
dc.subject	MICROBICIDES
dc.subject	MOTHER
dc.subject	MOTHER-TO-CHILD
dc.subject	MOTHER-TO-CHILD TRANSMISSION
dc.subject	MULTIPLE PARTNERS
dc.subject	NEGATIVE EFFECTS
dc.subject	NUCLEIC ACID
dc.subject	NUMBER OF NEW INFECTIONS
dc.subject	NURSE
dc.subject	NUTRITION
dc.subject	NUTRITIONAL STATUS
dc.subject	OBESITY
dc.subject	OCCUPATIONAL MEDICINE
dc.subject	OVERWEIGHT
dc.subject	PATIENT
dc.subject	PATIENT CARE
dc.subject	PATIENTS
dc.subject	PEER PRESSURE
dc.subject	POLICY DISCUSSIONS
dc.subject	POLICY RESEARCH
dc.subject	POLICY RESEARCH WORKING PAPER
dc.subject	POOR FAMILIES
dc.subject	POPULATION AND DEVELOPMENT
dc.subject	POPULATION REFERENCE BUREAU
dc.subject	PREGNANCIES
dc.subject	PREGNANCY
dc.subject	PRENATAL CARE
dc.subject	PREVALENCE OF SYPHILIS
dc.subject	PREVALENCE RATE
dc.subject	PREVENTION COUNSELING
dc.subject	PREVENTION EFFORTS
dc.subject	PREVENTION METHODS
dc.subject	PREVENTION STRATEGIES
dc.subject	PREVENTIVE HEALTH
dc.subject	PREVENTIVE MEDICINE
dc.subject	PROGRESS
dc.subject	PSYCHIATRY
dc.subject	PSYCHOLOGISTS
dc.subject	PSYCHOPHARMACOLOGY
dc.subject	PUBLIC HEALTH
dc.subject	PUBLIC SERVICES
dc.subject	RANDOMIZED CONTROLLED TRIALS
dc.subject	REPRODUCTIVE HEALTH
dc.subject	REPRODUCTIVE HEALTH SERVICES
dc.subject	RESPECT
dc.subject	RISK BEHAVIOR
dc.subject	RISK BEHAVIORS
dc.subject	RISK FACTORS
dc.subject	RISK GROUPS
dc.subject	RISK REDUCTION
dc.subject	RISK REDUCTION STRATEGIES
dc.subject	RISKY BEHAVIOR
dc.subject	RISKY BEHAVIORS
dc.subject	RISKY SEX
dc.subject	RISKY SEXUAL BEHAVIOR
dc.subject	RISKY SEXUAL BEHAVIORS
dc.subject	SAFE SEX
dc.subject	SCHOOLS
dc.subject	SERVICE PROVIDERS
dc.subject	SEX
dc.subject	SEX WORK
dc.subject	SEX WORKERS
dc.subject	SEXUAL ACTIVITY
dc.subject	SEXUAL BEHAVIOUR
dc.subject	SEXUAL CONTACT
dc.subject	SEXUAL ENCOUNTERS
dc.subject	SEXUAL HEALTH
dc.subject	SEXUAL INTERCOURSE
dc.subject	SEXUAL PARTNERS
dc.subject	SEXUAL PRACTICES
dc.subject	SEXUAL RELATIONSHIP
dc.subject	SEXUALLY TRANSMITTED INFECTION
dc.subject	SEXUALLY TRANSMITTED INFECTIONS
dc.subject	SMOKERS
dc.subject	SMOKING
dc.subject	SMOKING CESSATION
dc.subject	SOCIAL NORMS
dc.subject	SOCIAL STATUS
dc.subject	SOCIAL SUPPORT
dc.subject	SPOUSE
dc.subject	SPOUSES
dc.subject	STDS
dc.subject	STERILIZATION
dc.subject	STIS
dc.subject	SUBSTANCE ABUSE
dc.subject	SUBSTANCE ABUSE TREATMENT
dc.subject	SYPHILIS
dc.subject	TEEN
dc.subject	TEEN PREGNANCY
dc.subject	THERAPEUTIC APPROACH
dc.subject	THERAPY
dc.subject	TOBACCO
dc.subject	TOBACCO CONTROL
dc.subject	TOXICOLOGY
dc.subject	TREATMENT
dc.subject	TRICHOMONAS
dc.subject	UNAIDS
dc.subject	USE OF CONDOMS
dc.subject	VACCINATION
dc.subject	VACCINATION PROGRAMS
dc.subject	VACCINE
dc.subject	VACCINES
dc.subject	VIOLENCE
dc.subject	WEIGHT LOSS
dc.subject	WEIGHT REDUCTION
dc.subject	YOUNG ADULTS
dc.subject	YOUNG CHILDREN
dc.subject	YOUNG PEOPLE
dc.subject	YOUNG WOMEN
dc.title	Stimulating Demand for AIDS Prevention : Lessons from the RESPECT Trial
dc.type	Publications & Research :: Policy Research Working Paper
dc.coverage	Africa
dc.coverage	Africa
dc.coverage	Sub-Saharan Africa
dc.coverage	East Africa
dc.coverage	Tanzania