Swa Koteka: Cash transfers to tackle HIV among adolescents

Swa Koteka: Cash transfers to tackle HIV among adolescents

How might cash payments reduce transactional sex, thereby reducing the risk of HIV and unwanted pregnancy among young girls?

How do girls’ friendship networks affect their risk of acquiring HIV?

What is the overall cost effectiveness of a cash transfer intervention?

These questions are part of STRIVE’s research agenda for Swa Koteka, a trial of cash transfers for HIV prevention among adolescent women in rural South Africa. Through a collaboration between Wits Reproductive Health and HIV Institute (WRHI) and the London School of Hygiene & Tropical Medicine (LSHTM), STRIVE is supporting three doctoral research projects to explore structural issues related to cash transfers conditional on school attendance.

What are the economic motivators of transactional sex in rural South Africa?

A mixed qualitative and quantitative study, with quantitative analysis using baseline data from Swa Koteka. Research questions include:

  • What are girl’s hierarchies of needs in rural South Africa?
  • Is transactional sex an important source of income for poor households?
  • Is household poverty strongly associated with a girl engaging in transactional sex or being HIV infected?
  • To what extent is consumerism and a desire to obtain ‘luxury’ items motivating girl’s engagement in transactional sex?
  • What are the implications for interventions focusing on transactional sex and HIV?

Impact of friendship networks on young women’s sexual behaviour and condom use

A mixed qualitative and quantitative study, with quantitative analysis using baseline data from Swa Koteka. Research questions include:

  • Do the characteristics of a young woman’s friends have an association with her age of sexual debut, sexual behaviour and HSV2 status?
  • Is there an association between the demographic composition and characteristics of young women’s friendships and the characteristics of her sexual partners/ partnerships, and condom use?
  • Is there an association between discussing condom use with friends and condom use in young women who have reported ever having had sex?          

Economic evaluation of Swa Koteka

A full economic costing of the delivery of the conditional cash transfer programme (excluding research-related costs) and secondary analysis of trial data, to produce estimates of the magnitude of the benefits of the CCT intervention. The study also includes a cost-effectiveness and benefit/cost ratio analysis. Research questions include:

  • What are the costs of delivering a conditional cash transfer programme to keep girls in rural South Africa?
  • What are the main drivers of these costs?

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