AIDS and Behavior

, Volume 16, Issue 7, pp 1729–1738 | Cite as

Can Money Prevent the Spread of HIV? A Review of Cash Payments for HIV Prevention

  • Audrey PettiforEmail author
  • Catherine MacPhail
  • Nadia Nguyen
  • Molly Rosenberg
Substantive Review


Cash payments to improve health outcomes have been used for many years; however, their use for HIV prevention is new and the impact not yet well understood. We provide a brief background on the rationale behind using cash to improve health outcomes, review current studies completed or underway using cash for prevention of sexual transmission of HIV, and outline some key considerations on the use of cash payments to prevent HIV infections. We searched the literature for studies that implemented cash transfer programs and measured HIV or HIV-related outcomes. We identified 16 studies meeting our criteria; 10 are completed. The majority of studies have been conducted with adolescents in developing countries and payments are focused on addressing structural risk factors such as poverty. Most have seen reductions in sexual behavior and one large trial has documented a difference in HIV prevalence between young women getting cash transfers and those not. Cash transfer programs focused on changing risky sexual behaviors to reduce HIV risk suggest promise. The context in which programs are situated, the purpose of the cash transfer, and the population will all affect the impact of such programs; ongoing RCTs with HIV incidence endpoints will shed more light on the efficacy of cash payments as strategy for HIV prevention.


HIV Incentives Cash transfer Reward Incentive Contingency management Social protection Prevention Sexual behavior Review 


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Audrey Pettifor
    • 1
    Email author
  • Catherine MacPhail
    • 2
  • Nadia Nguyen
    • 1
  • Molly Rosenberg
    • 1
  1. 1.Department of Epidemiology, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.Wits Reproductive Health and HIV Research InstituteJohannesburgSouth Africa

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