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Women’s Relationship Power Modifies the Effect of a Randomized Conditional Cash Transfer Intervention for Safer Sex in Tanzania

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Abstract

This study tests whether women’s relationship power modifies the effect of a conditional cash transfer (CCT) on STI risk. We analyzed 988 women enrolled in the RESPECT study in Tanzania, a yearlong, randomized-controlled trial testing the effectiveness of a CCT to reduce STI incidence. Women were randomized at the individual level to a no-cash control group, a low-cash, or a high-cash study arm. After one year, there was no main effect of study arm on risk of having an STI among women. However, in tests of heterogeneity, the effect of the CCT varied by a woman’s relationship power (adjusted RRs of the interaction term for women with higher relationship power: RR 0.567 (95% CI 0.240–0.895) for high cash and RR 1.217 (95% CI 0.794–1.641) for low cash). Specifically, women with higher relationship power in the low cash transfer arm had an elevated risk of testing positive for an STI, whereas women with high relationship power in the high cash transfer arm had a decreased risk of testing positive for an STI.

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Acknowledgements

We gratefully acknowledge funding support for the overall RESPECT project from the William and Flora Hewlett Foundation (through the Population Reference Bureau), the World Bank Research Committee, the Strategic Impact Evaluation Fund (SIEF), the Bank- Netherlands Partnership Program (BNPP), Trust Fund for Environmentally & Socially Sustainable Development (TFESSD) and Knowledge for Change Program (KCP), managed by the World Bank. The findings, interpretations, and conclusions expressed in this paper are entirely those of the authors. They do not necessarily represent the views of the authors’ institutions or funders or of the International Bank for Reconstruction and Development/World Bank and its affiliated organizations, or those of the Executive Directors of the World Bank or the governments they represent.

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Authors and Affiliations

  1. School of Public Health, University of California Berkeley, Berkeley, CA, USA

    Jan E. Cooper, Sandra I. McCoy, Lia C. H. Fernald & William H. Dow

  2. Development Research Group, The World Bank, Washington, DC, USA

    Damien de Walque

  3. University of California, 417P University Hall, 50 University Hall, MC #7360, Berkeley, CA, 94720-7360, USA

    Jan E. Cooper

Authors
  1. Jan E. Cooper
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  2. Sandra I. McCoy
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  3. Lia C. H. Fernald
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  4. Damien de Walque
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  5. William H. Dow
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Corresponding author

Correspondence to Jan E. Cooper.

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Conflicts of interest

All authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Appendices

Appendix 1

See Table 5.

Table 5 Full sexual and reproductive power scale, questions included in the RESPECT questionnaire, and questions retained through PCA included in this analysis
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Appendix 2

See Fig. 2.

Fig. 2
figure 2

Kernel density curve of baseline relationship power for women in the RESPECT CCT in Tanzania

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Cooper, J.E., McCoy, S.I., Fernald, L.C.H. et al. Women’s Relationship Power Modifies the Effect of a Randomized Conditional Cash Transfer Intervention for Safer Sex in Tanzania. AIDS Behav 22, 202–211 (2018). https://doi.org/10.1007/s10461-017-1875-6

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  • DOI: https://doi.org/10.1007/s10461-017-1875-6

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