South Africa: Cash Cure for the AIDS Epidemic?

A trial in KwaZulu-Natal province is testing whether a cash-incentivized program targeting students can significantly reduce their HIV risk. Launched last September by the Center for the AIDS Program of Research in South Africa (CAPRISA), the study involves youths age 13 and older at seven intervention schools and seven control schools.

A similar trial in Malawi, presented at the 2010 International AIDS Conference in Vienna, simply offered girls cash to stay in school. The HIV infection rate was 60 percent lower among girls who received the money. However, the trial was not structured as an HIV study, so it could not say whether the intervention and control groups had similar HIV infection rates at baseline, said Quarraisha Abdool Karim, lead researcher of CAPRISA's RHIVA (Reducing HIV in Adolescents) trial in KwaZulu-Natal.

The RHIVA study aims to determine whether financial rewards for getting good grades and undergoing annual HIV tests can help the girls take fewer sexual risks.

"Study participants are taught life-orientation skills, including how to manage their personal finances," said Jerome Singh, RHIVA trial ethicist and ethics director of Grand Challenges in Global Health, an initiative funded by the Bill & Melinda Gates Foundation. The RHIVA trial, set to run until the end of 2012, will also attempt to influence males' behavior toward being less risky.

"We have to think out of the box," Abdool Karim said. "Young women are infected before they even have a glimpse of what their life could be like." HIV prevalence is about 2 percent among 14-year-old South African girls, but by age 20 it can be as high as 16 percent.

Back to other news for June 2011