Effects of Cash Transfer for the Prevention of HIV in Young South African Women

Study Overview
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Brief Summary
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Cash transfers to young women for staying in school and its effect on acquiring HIV

Detailed Description
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The overall purpose of this study is to determine whether providing cash transfers to young women and their household, conditional on school attendance, reduces young women's risk of acquiring Human Immunodeficiency Virus (HIV). The overall goal of the Conditional Cash Transfer (CCT) intervention is to reduce structural barriers to education with the goal of increasing school attendance of young women, thereby decreasing their HIV risk.

Official Title
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Effects of Cash Transfer for the Prevention of HIV in Young South African Women

Conditions
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HIV

Intervention / Treatment
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* Behavioral: monthly cash transfer payments for attending school
* Behavioral: B--No cash transfers


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Female aged 13 to 20 years. Enrolled in grades 8, 9, 10 or 11 at the beginning of the study at schools in the AHDSS study site Intending to continue to live in the study site until the end of the follow-up period. Be willing and able to consent/assent to all study procedures including HIV and HSV-2 testing. Able to read sufficiently to use ACASI. Have a bank or post office account or have documentation to be able to open a bank or post office account (i.e., birth certificate, South African National Identification Book, or passport and proof of residence). Post Office accounts will only be required for participants in the Intervention arm. Parent/Legal Guardian who lives with young woman, willing and able to consent to all study procedures including HIV and HSV-2 testing. Parent/Legal Guardian has a bank or post office account or has documentation to be able to open a bank or post office account (i.e. South African National Identification Book, or passport and proof of residence). Note that the account may be opened in the name of any adult who resides in the household with the young woman. Exclusion Criteria: Pregnant by self-report at baseline. Married at baseline. No parent or legal guardian living in household. Any other reason that the staff feels would jeopardize the health or well-being of the participant or staff or would prevent proper conduct of the study.

Ages Eligible for Study
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Minimum Age: 13 Years
Maximum Age: 20 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: A--Monthly cash transfers<br>Monthly cash transfer payments | Behavioral: monthly cash transfer payments for attending school<br>* In the intervention, young women and their households will be randomized in 1:1 ratio to receive monthly cash transfer payments, conditional on the young woman attending school, or to the control arm. Young women will be recruited at the beginning of grades 8 through 11 in the first year of the study.<br>|
| Other: B--No cash transfers<br>No cash transfers. | Behavioral: monthly cash transfer payments for attending school<br>* In the intervention, young women and their households will be randomized in 1:1 ratio to receive monthly cash transfer payments, conditional on the young woman attending school, or to the control arm. Young women will be recruited at the beginning of grades 8 through 11 in the first year of the study.<br>Behavioral: B--No cash transfers<br>* No monthly cash transfers<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| HIV Incidence | To determine whether young women who are randomized to receive CCTs conditional on school attendance have a lower incidence of HIV infection over time compared to young women who are not randomized to receive cash transfers. | 4 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| HSV-2 incidence | To determine whether young women who are randomized to receive CCTs conditional on school attendance have a lower incidence of Herpes Simplex Virus type 2 (HSV-2) infections over time compared to young women who are not randomized to receive cash transfers. | 4 years | 
| HSV Incidence | To determine whether young women who receive the CCTs report less unprotected sex, fewer number of sexual partners, younger male partners, an older age of coital debut, a lower incidence of self-reported pregnancy, and greater school attendance compared to young women who do not receive the cash transfers. | 4 years |