AIDS and Behavior

, Volume 14, Issue 6, pp 1393–1400 | Cite as

Social Grants, Welfare, and the Incentive to Trade-Off Health for Income among Individuals on HAART in South Africa

  • Atheendar S. VenkataramaniEmail author
  • Brendan Maughan-Brown
  • Nicoli Nattrass
  • Jennifer Prah Ruger
Original Paper


South Africa’s government disability grants are considered important in providing income support to low-income AIDS patients. Indeed, anecdotal evidence suggests that some individuals may opt to compromise their health by foregoing Highly Active Antiretroviral Treatment (HAART) to remain eligible for the grant. In this study, we examined the disability grant’s importance to individual and household welfare, and the impact of its loss using a unique longitudinal dataset of HAART patients in Khayelitsha, Cape Town. We found that grant loss was associated with sizeable declines in income and changes in household composition. However, we found no evidence of individuals choosing poor health over grant loss. Our analysis also suggested that though the grants officially target those too sick to work, some people were able to keep grants longer than expected, and others received grants while employed. This has helped cushion people on HAART, but other welfare measures need consideration.


AIDS Highly active antiretroviral therapy (HAART) Incentives Social security South Africa Trade-offs Welfare 



We would like to thank the AIDS and Society Research Unit (ASRU) at the University of Cape Town for access to data from the HAART Panel Study and for research support. We would also like to thank Nathan Geffen, Elijah Paintsil, A. David Paltiel, Gustav Ranis, Jeremy Seekings, Jody Sindelar, T. Paul Schultz, T.N. Srinivasan, seminar participants at the University of Cape Town Center for Social Science Research, the Center for Interdisciplinary Research on AIDS at Yale University, the Global Citizenship: Research Implications workshop, and the International Health Economics Association 7th World Congress, as well as two anonymous referees, for helpful comments and suggestions. Funding for this research was provided by ASRU, the Whitney and Betty MacMillan Center for International and Area Studies at Yale University, and the William and Flora Hewlett Foundation. All errors are our own.


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Atheendar S. Venkataramani
    • 1
    Email author
  • Brendan Maughan-Brown
    • 2
  • Nicoli Nattrass
    • 2
  • Jennifer Prah Ruger
    • 3
  1. 1.Washington University School of Medicine in St. LouisSt. LouisUSA
  2. 2.AIDS and Society Research UnitUniversity of Cape TownCape TownSouth Africa
  3. 3.Division of Health Policy and AdministrationYale University School of Public HealthNew HavenUSA

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