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Acceptability and Feasibility of Cash Transfers for HIV Prevention Among Adolescent South African Women

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Abstract

Women are at increased risk of HIV infection in much of sub-Saharan Africa. Longitudinal and cross-sectional studies have found an association between school attendance and reduced HIV risk. We report feasibility and acceptability results from a pilot of a cash transfer intervention conditional on school attendance paid to young women and their families in rural Mpumalanga, South Africa for the prevention of HIV infection. Twenty-nine young women were randomised to intervention or control and a cash payment based on school attendance made over a 2-month period. Quantitative (survey) and qualitative (focus group and interview) data collection was undertaken with young women, parents, teachers and young men in the same school. Qualitative analysis was conducted in Atlas.ti using a framework approach and basic descriptive analysis in Excel was conducted on the quantitative data. Results indicate it was both feasible and acceptable to introduce such an intervention among this population in rural South Africa. There was good understanding of the process of randomisation and the aims of the study, although some rumours developed in the study community. We address some of the changes necessary to ensure acceptability and feasibility of the main trial.

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Acknowledgments

The authors would like to acknowledge the young women and their parents who participated in this study and the field team who collected the data. Financial support for the research and authorship of this article was obtained from HPTN 068, a Grant (1RO1MH087118-01) from the National Institutes of Mental Health and funding from the Regional Network on AIDS, Livelihoods and Food Security (RENEWAL).

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Authors and Affiliations

  1. Wits Reproductive Health and HIV Institute (WRHI), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

    Catherine MacPhail

  2. Collaborative Research Network (CRN) for Mental Health and Well-being of Rural and Regional Communities, University of New England, Room 261A, Botany Building, Armidale, NSW, 2350, Australia

    Catherine MacPhail

  3. Regional Network on AIDS, Livelihoods, and Food Security (RENEWAL), International Food Policy Research Institute (IFPRI), Washington DC, USA

    Michelle Adato & Elizabeth Becker

  4. Wits/MRC Rural Public Health and Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa

    Kathleen Kahn, Rhian Twine & Samson Khoza

  5. Gillings School of Public Health, University of North Carolina, Chapel Hill, NC, USA

    Amanda Selin, Molly Rosenberg, Nadia Nguyen & Audrey Pettifor

Authors
  1. Catherine MacPhail
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  2. Michelle Adato
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  3. Kathleen Kahn
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  4. Amanda Selin
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  5. Rhian Twine
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  6. Samson Khoza
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  7. Molly Rosenberg
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  8. Nadia Nguyen
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  9. Elizabeth Becker
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  10. Audrey Pettifor
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Correspondence to Catherine MacPhail.

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MacPhail, C., Adato, M., Kahn, K. et al. Acceptability and Feasibility of Cash Transfers for HIV Prevention Among Adolescent South African Women. AIDS Behav 17, 2301–2312 (2013). https://doi.org/10.1007/s10461-013-0433-0

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  • DOI: https://doi.org/10.1007/s10461-013-0433-0

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