Exploring the potential of a conditional cash transfer intervention to reduce HIV risk among young women in Iringa, Tanzania

Abstract

Cash transfer programs seek to alter structural determinants of HIV risk such as poverty and gender inequality. We sought to explore the feasibility and potential effectiveness of a cash transfer intervention for young women as part of combination HIV prevention in Iringa, Tanzania. Qualitative, in-depth interviews were conducted with 116 stakeholders and residents from the region, including key informants, service delivery users, and members of key populations. Most respondents felt a cash transfer program would assist young women in Iringa to have more control over sexual decision-making and reduce poverty-driven transactional sex. Respondents were divided on who should receive funds: young women themselves, their parents/guardians, or community leaders. Cash amounts and suggested target groups varied, and several respondents suggested providing microcredit or small business capital instead of cash. Potential concerns included jealousy, dependency, and corruption. However, most respondents felt that some intervention was needed to address underlying poverty driving some sexual risk behavior. A cash transfer program could fill this role, ultimately reducing HIV, sexually transmitted infections, and unintended pregnancies. As increased attention is given to economic and structural interventions for HIV prevention, local input and knowledge should be considered in a program design.

Keywords:

• cash transfer
• HIV prevention
• structural interventions
• Tanzania
• qualitative research

Acknowledgments

The authors would like to thank the ethnographers who conducted interviews as well as all the study respondents. We appreciate the support and contributions from all the many individuals who have contributed in a wide variety of ways to this study and the Research to Prevention (R2P) project. This work was supported by USAID | Project SEARCH, Task Order No. 2, funded by the US Agency for International Development under Contract No. GHH-I-00-07-00032-00, beginning 30 September 2008, and supported by the President's Emergency Plan for AIDS Relief.