Stimulating Demand for AIDS Prevention : Lessons from the RESPECT Trial
HIV-prevention strategies have yielded only limited success so far in slowing down the AIDS epidemic. This paper examines novel intervention strategies that use incentives to discourage risky sexual behaviors. Widely-adopted conditional cash transf...
| Main Authors: | , , , |
|---|---|
| Format: | Policy Research Working Paper |
| Language: | English |
| Published: |
2012
|
| Subjects: | |
| Online Access: | http://www-wds.worldbank.org/external/default/main?menuPK=64187510&pagePK=64193027&piPK=64187937&theSitePK=523679&menuPK=64187510&searchMenuPK=64187283&siteName=WDS&entityID=000158349_20120221132307 http://hdl.handle.net/10986/3259 |
| id |
okr-10986-3259 |
|---|---|
| recordtype |
oai_dc |
| repository_type |
Digital Repository |
| institution_category |
Foreign Institution |
| institution |
Digital Repositories |
| building |
World Bank Open Knowledge Repository |
| collection |
World Bank |
| language |
English |
| topic |
ABSTINENCE ADDICTION ADDICTIVE BEHAVIORS ADOLESCENT ADOLESCENT GIRL ADULT PREVALENCE ADULT PREVALENCE RATE AGED AIDS EPIDEMIC AIDS PANDEMIC AIDS PATIENT AIDS PREVENTION AIDS VACCINE ALCOHOL ALCOHOL ABUSE ALCOHOL DEPENDENCE ALCOHOL USE ANAL SEX ANTENATAL CARE ANTIVIRALS BEHAVIOR CHANGE BEHAVIORAL CHANGE BEHAVIORAL CHANGES BLOOD PRESSURE BLOOD TESTS BS CHILD CARE CHILD HEALTH CHILD HEALTH CARE CHLAMYDIA CIRCUMCISION CLINICAL PSYCHOLOGY CLINICAL TRIALS CLINICS COCAINE COMMERCIAL SEX COMPLICATIONS CONDOM CONDOM PROMOTION CONDOM USE CONDOMS CONTRACEPTION CONTRACEPTIVE PREVALENCE COST EFFECTIVENESS COUNSELING INTERVENTION DEVELOPING COUNTRIES DEVELOPMENT POLICY DEVELOPMENTAL PSYCHOLOGY DIAGNOSIS DISEASE DISEASE CONTROL DISEASE TRANSMISSION DRUG ABUSE DRUG USE DRUGS EARLY YEARS EDUCATIONAL SERVICES ETHICAL CONSIDERATIONS FAMILIES FAMILY PLANNING FEMALES FINANCIAL CONSTRAINTS FOCUS GROUP DISCUSSIONS GLOBAL AIDS EPIDEMIC GLOBAL HEALTH GONORRHEA HEALTH CARE HEALTH CARE SERVICES HEALTH CONSEQUENCES HEALTH EDUCATION HEALTH IMPACT HEALTH INTERVENTIONS HEALTH OUTCOMES HEALTH SERVICES HEALTH SYSTEMS HIGH RISK GROUPS HIV HIV INFECTIONS HIV POSITIVE HIV PREVENTION HIV TESTING HIV TRANSMISSION HIV/AIDS HUMAN CAPITAL HUMAN DEVELOPMENT ILLNESS IMMUNIZATION IMPACT ON HEALTH INFECTION INFECTION PREVENTION INFORMED CONSENT INTERNATIONAL FAMILY PLANNING INTERNATIONAL FAMILY PLANNING PERSPECTIVES INTERVENTION JOURNAL OF MEDICINE LACK OF INFORMATION LOW PREVALENCE MALE CIRCUMCISION MALE SEX MALE SEX WORKERS MASS COMMUNICATION MEDICAL RESEARCH MEDICATION MEDICINES METHADONE METHADONE PATIENTS MICROBICIDES MOTHER MOTHER-TO-CHILD MOTHER-TO-CHILD TRANSMISSION MULTIPLE PARTNERS NEGATIVE EFFECTS NUCLEIC ACID NUMBER OF NEW INFECTIONS NURSE NUTRITION NUTRITIONAL STATUS OBESITY OCCUPATIONAL MEDICINE OVERWEIGHT PATIENT PATIENT CARE PATIENTS PEER PRESSURE POLICY DISCUSSIONS POLICY RESEARCH POLICY RESEARCH WORKING PAPER POOR FAMILIES POPULATION AND DEVELOPMENT POPULATION REFERENCE BUREAU PREGNANCIES PREGNANCY PRENATAL CARE PREVALENCE OF SYPHILIS PREVALENCE RATE PREVENTION COUNSELING PREVENTION EFFORTS PREVENTION METHODS PREVENTION STRATEGIES PREVENTIVE HEALTH PREVENTIVE MEDICINE PROGRESS PSYCHIATRY PSYCHOLOGISTS PSYCHOPHARMACOLOGY PUBLIC HEALTH PUBLIC SERVICES RANDOMIZED CONTROLLED TRIALS REPRODUCTIVE HEALTH REPRODUCTIVE HEALTH SERVICES RESPECT RISK BEHAVIOR RISK BEHAVIORS RISK FACTORS RISK GROUPS RISK REDUCTION RISK REDUCTION STRATEGIES RISKY BEHAVIOR RISKY BEHAVIORS RISKY SEX RISKY SEXUAL BEHAVIOR RISKY SEXUAL BEHAVIORS SAFE SEX SCHOOLS SERVICE PROVIDERS SEX SEX WORK SEX WORKERS SEXUAL ACTIVITY SEXUAL BEHAVIOUR SEXUAL CONTACT SEXUAL ENCOUNTERS SEXUAL HEALTH SEXUAL INTERCOURSE SEXUAL PARTNERS SEXUAL PRACTICES SEXUAL RELATIONSHIP SEXUALLY TRANSMITTED INFECTION SEXUALLY TRANSMITTED INFECTIONS SMOKERS SMOKING SMOKING CESSATION SOCIAL NORMS SOCIAL STATUS SOCIAL SUPPORT SPOUSE SPOUSES STDS STERILIZATION STIS SUBSTANCE ABUSE SUBSTANCE ABUSE TREATMENT SYPHILIS TEEN TEEN PREGNANCY THERAPEUTIC APPROACH THERAPY TOBACCO TOBACCO CONTROL TOXICOLOGY TREATMENT TRICHOMONAS UNAIDS USE OF CONDOMS VACCINATION VACCINATION PROGRAMS VACCINE VACCINES VIOLENCE WEIGHT LOSS WEIGHT REDUCTION YOUNG ADULTS YOUNG CHILDREN YOUNG PEOPLE YOUNG WOMEN |
| spellingShingle |
ABSTINENCE ADDICTION ADDICTIVE BEHAVIORS ADOLESCENT ADOLESCENT GIRL ADULT PREVALENCE ADULT PREVALENCE RATE AGED AIDS EPIDEMIC AIDS PANDEMIC AIDS PATIENT AIDS PREVENTION AIDS VACCINE ALCOHOL ALCOHOL ABUSE ALCOHOL DEPENDENCE ALCOHOL USE ANAL SEX ANTENATAL CARE ANTIVIRALS BEHAVIOR CHANGE BEHAVIORAL CHANGE BEHAVIORAL CHANGES BLOOD PRESSURE BLOOD TESTS BS CHILD CARE CHILD HEALTH CHILD HEALTH CARE CHLAMYDIA CIRCUMCISION CLINICAL PSYCHOLOGY CLINICAL TRIALS CLINICS COCAINE COMMERCIAL SEX COMPLICATIONS CONDOM CONDOM PROMOTION CONDOM USE CONDOMS CONTRACEPTION CONTRACEPTIVE PREVALENCE COST EFFECTIVENESS COUNSELING INTERVENTION DEVELOPING COUNTRIES DEVELOPMENT POLICY DEVELOPMENTAL PSYCHOLOGY DIAGNOSIS DISEASE DISEASE CONTROL DISEASE TRANSMISSION DRUG ABUSE DRUG USE DRUGS EARLY YEARS EDUCATIONAL SERVICES ETHICAL CONSIDERATIONS FAMILIES FAMILY PLANNING FEMALES FINANCIAL CONSTRAINTS FOCUS GROUP DISCUSSIONS GLOBAL AIDS EPIDEMIC GLOBAL HEALTH GONORRHEA HEALTH CARE HEALTH CARE SERVICES HEALTH CONSEQUENCES HEALTH EDUCATION HEALTH IMPACT HEALTH INTERVENTIONS HEALTH OUTCOMES HEALTH SERVICES HEALTH SYSTEMS HIGH RISK GROUPS HIV HIV INFECTIONS HIV POSITIVE HIV PREVENTION HIV TESTING HIV TRANSMISSION HIV/AIDS HUMAN CAPITAL HUMAN DEVELOPMENT ILLNESS IMMUNIZATION IMPACT ON HEALTH INFECTION INFECTION PREVENTION INFORMED CONSENT INTERNATIONAL FAMILY PLANNING INTERNATIONAL FAMILY PLANNING PERSPECTIVES INTERVENTION JOURNAL OF MEDICINE LACK OF INFORMATION LOW PREVALENCE MALE CIRCUMCISION MALE SEX MALE SEX WORKERS MASS COMMUNICATION MEDICAL RESEARCH MEDICATION MEDICINES METHADONE METHADONE PATIENTS MICROBICIDES MOTHER MOTHER-TO-CHILD MOTHER-TO-CHILD TRANSMISSION MULTIPLE PARTNERS NEGATIVE EFFECTS NUCLEIC ACID NUMBER OF NEW INFECTIONS NURSE NUTRITION NUTRITIONAL STATUS OBESITY OCCUPATIONAL MEDICINE OVERWEIGHT PATIENT PATIENT CARE PATIENTS PEER PRESSURE POLICY DISCUSSIONS POLICY RESEARCH POLICY RESEARCH WORKING PAPER POOR FAMILIES POPULATION AND DEVELOPMENT POPULATION REFERENCE BUREAU PREGNANCIES PREGNANCY PRENATAL CARE PREVALENCE OF SYPHILIS PREVALENCE RATE PREVENTION COUNSELING PREVENTION EFFORTS PREVENTION METHODS PREVENTION STRATEGIES PREVENTIVE HEALTH PREVENTIVE MEDICINE PROGRESS PSYCHIATRY PSYCHOLOGISTS PSYCHOPHARMACOLOGY PUBLIC HEALTH PUBLIC SERVICES RANDOMIZED CONTROLLED TRIALS REPRODUCTIVE HEALTH REPRODUCTIVE HEALTH SERVICES RESPECT RISK BEHAVIOR RISK BEHAVIORS RISK FACTORS RISK GROUPS RISK REDUCTION RISK REDUCTION STRATEGIES RISKY BEHAVIOR RISKY BEHAVIORS RISKY SEX RISKY SEXUAL BEHAVIOR RISKY SEXUAL BEHAVIORS SAFE SEX SCHOOLS SERVICE PROVIDERS SEX SEX WORK SEX WORKERS SEXUAL ACTIVITY SEXUAL BEHAVIOUR SEXUAL CONTACT SEXUAL ENCOUNTERS SEXUAL HEALTH SEXUAL INTERCOURSE SEXUAL PARTNERS SEXUAL PRACTICES SEXUAL RELATIONSHIP SEXUALLY TRANSMITTED INFECTION SEXUALLY TRANSMITTED INFECTIONS SMOKERS SMOKING SMOKING CESSATION SOCIAL NORMS SOCIAL STATUS SOCIAL SUPPORT SPOUSE SPOUSES STDS STERILIZATION STIS SUBSTANCE ABUSE SUBSTANCE ABUSE TREATMENT SYPHILIS TEEN TEEN PREGNANCY THERAPEUTIC APPROACH THERAPY TOBACCO TOBACCO CONTROL TOXICOLOGY TREATMENT TRICHOMONAS UNAIDS USE OF CONDOMS VACCINATION VACCINATION PROGRAMS VACCINE VACCINES VIOLENCE WEIGHT LOSS WEIGHT REDUCTION YOUNG ADULTS YOUNG CHILDREN YOUNG PEOPLE YOUNG WOMEN de Walque, Damien Dow, William H. Medlin, Carol Nathan, Rose Stimulating Demand for AIDS Prevention : Lessons from the RESPECT Trial |
| geographic_facet |
Africa Africa Sub-Saharan Africa East Africa Tanzania |
| relation |
Paper is funded by the Knowledge for Change
Program (KCP),Policy Research working paper ; no. WPS 5973 |
| description |
HIV-prevention strategies have yielded
only limited success so far in slowing down the AIDS
epidemic. This paper examines novel intervention strategies
that use incentives to discourage risky sexual behaviors.
Widely-adopted conditional cash transfer programs that offer
payments conditioning on easily monitored behaviors, such as
well-child health care visits, have shown positive impact on
health outcomes. Similarly, contingency management
approaches have successfully used outcome-based rewards to
encourage behaviors that are not easily monitored, such as
stopping drug abuse. These strategies have not been used in
the sexual domain, so this paper assesses how incentives can
be used to reduce risky sexual behavior. After discussing
theoretical pathways, it discusses the use of
sexual-behavior incentives in the Tanzanian RESPECT trial.
There, participants who tested negative for sexually
transmitted infections are eligible for outcome-based cash
rewards. The trial was well-received in the communities,
with high enrollment rates and more than 90 percent of
participants viewing the incentives favorably. After one
year, 57 percent of enrollees in the "low-value"
reward arm stated that the cash rewards "very
much" motivated sexual behavioral change, rising to 79
percent in the "high-value" reward arm. Despite
its controversial nature, the authors argue for further
testing of such incentive-based approaches to encouraging
reductions in risky sexual behavior. |
| format |
Publications & Research :: Policy Research Working Paper |
| author |
de Walque, Damien Dow, William H. Medlin, Carol Nathan, Rose |
| author_facet |
de Walque, Damien Dow, William H. Medlin, Carol Nathan, Rose |
| author_sort |
de Walque, Damien |
| title |
Stimulating Demand for AIDS Prevention : Lessons from the RESPECT Trial |
| title_short |
Stimulating Demand for AIDS Prevention : Lessons from the RESPECT Trial |
| title_full |
Stimulating Demand for AIDS Prevention : Lessons from the RESPECT Trial |
| title_fullStr |
Stimulating Demand for AIDS Prevention : Lessons from the RESPECT Trial |
| title_full_unstemmed |
Stimulating Demand for AIDS Prevention : Lessons from the RESPECT Trial |
| title_sort |
stimulating demand for aids prevention : lessons from the respect trial |
| publishDate |
2012 |
| url |
http://www-wds.worldbank.org/external/default/main?menuPK=64187510&pagePK=64193027&piPK=64187937&theSitePK=523679&menuPK=64187510&searchMenuPK=64187283&siteName=WDS&entityID=000158349_20120221132307 http://hdl.handle.net/10986/3259 |
| _version_ |
1764386692330946560 |
| spelling |
okr-10986-32592021-04-23T14:02:08Z Stimulating Demand for AIDS Prevention : Lessons from the RESPECT Trial de Walque, Damien Dow, William H. Medlin, Carol Nathan, Rose ABSTINENCE ADDICTION ADDICTIVE BEHAVIORS ADOLESCENT ADOLESCENT GIRL ADULT PREVALENCE ADULT PREVALENCE RATE AGED AIDS EPIDEMIC AIDS PANDEMIC AIDS PATIENT AIDS PREVENTION AIDS VACCINE ALCOHOL ALCOHOL ABUSE ALCOHOL DEPENDENCE ALCOHOL USE ANAL SEX ANTENATAL CARE ANTIVIRALS BEHAVIOR CHANGE BEHAVIORAL CHANGE BEHAVIORAL CHANGES BLOOD PRESSURE BLOOD TESTS BS CHILD CARE CHILD HEALTH CHILD HEALTH CARE CHLAMYDIA CIRCUMCISION CLINICAL PSYCHOLOGY CLINICAL TRIALS CLINICS COCAINE COMMERCIAL SEX COMPLICATIONS CONDOM CONDOM PROMOTION CONDOM USE CONDOMS CONTRACEPTION CONTRACEPTIVE PREVALENCE COST EFFECTIVENESS COUNSELING INTERVENTION DEVELOPING COUNTRIES DEVELOPMENT POLICY DEVELOPMENTAL PSYCHOLOGY DIAGNOSIS DISEASE DISEASE CONTROL DISEASE TRANSMISSION DRUG ABUSE DRUG USE DRUGS EARLY YEARS EDUCATIONAL SERVICES ETHICAL CONSIDERATIONS FAMILIES FAMILY PLANNING FEMALES FINANCIAL CONSTRAINTS FOCUS GROUP DISCUSSIONS GLOBAL AIDS EPIDEMIC GLOBAL HEALTH GONORRHEA HEALTH CARE HEALTH CARE SERVICES HEALTH CONSEQUENCES HEALTH EDUCATION HEALTH IMPACT HEALTH INTERVENTIONS HEALTH OUTCOMES HEALTH SERVICES HEALTH SYSTEMS HIGH RISK GROUPS HIV HIV INFECTIONS HIV POSITIVE HIV PREVENTION HIV TESTING HIV TRANSMISSION HIV/AIDS HUMAN CAPITAL HUMAN DEVELOPMENT ILLNESS IMMUNIZATION IMPACT ON HEALTH INFECTION INFECTION PREVENTION INFORMED CONSENT INTERNATIONAL FAMILY PLANNING INTERNATIONAL FAMILY PLANNING PERSPECTIVES INTERVENTION JOURNAL OF MEDICINE LACK OF INFORMATION LOW PREVALENCE MALE CIRCUMCISION MALE SEX MALE SEX WORKERS MASS COMMUNICATION MEDICAL RESEARCH MEDICATION MEDICINES METHADONE METHADONE PATIENTS MICROBICIDES MOTHER MOTHER-TO-CHILD MOTHER-TO-CHILD TRANSMISSION MULTIPLE PARTNERS NEGATIVE EFFECTS NUCLEIC ACID NUMBER OF NEW INFECTIONS NURSE NUTRITION NUTRITIONAL STATUS OBESITY OCCUPATIONAL MEDICINE OVERWEIGHT PATIENT PATIENT CARE PATIENTS PEER PRESSURE POLICY DISCUSSIONS POLICY RESEARCH POLICY RESEARCH WORKING PAPER POOR FAMILIES POPULATION AND DEVELOPMENT POPULATION REFERENCE BUREAU PREGNANCIES PREGNANCY PRENATAL CARE PREVALENCE OF SYPHILIS PREVALENCE RATE PREVENTION COUNSELING PREVENTION EFFORTS PREVENTION METHODS PREVENTION STRATEGIES PREVENTIVE HEALTH PREVENTIVE MEDICINE PROGRESS PSYCHIATRY PSYCHOLOGISTS PSYCHOPHARMACOLOGY PUBLIC HEALTH PUBLIC SERVICES RANDOMIZED CONTROLLED TRIALS REPRODUCTIVE HEALTH REPRODUCTIVE HEALTH SERVICES RESPECT RISK BEHAVIOR RISK BEHAVIORS RISK FACTORS RISK GROUPS RISK REDUCTION RISK REDUCTION STRATEGIES RISKY BEHAVIOR RISKY BEHAVIORS RISKY SEX RISKY SEXUAL BEHAVIOR RISKY SEXUAL BEHAVIORS SAFE SEX SCHOOLS SERVICE PROVIDERS SEX SEX WORK SEX WORKERS SEXUAL ACTIVITY SEXUAL BEHAVIOUR SEXUAL CONTACT SEXUAL ENCOUNTERS SEXUAL HEALTH SEXUAL INTERCOURSE SEXUAL PARTNERS SEXUAL PRACTICES SEXUAL RELATIONSHIP SEXUALLY TRANSMITTED INFECTION SEXUALLY TRANSMITTED INFECTIONS SMOKERS SMOKING SMOKING CESSATION SOCIAL NORMS SOCIAL STATUS SOCIAL SUPPORT SPOUSE SPOUSES STDS STERILIZATION STIS SUBSTANCE ABUSE SUBSTANCE ABUSE TREATMENT SYPHILIS TEEN TEEN PREGNANCY THERAPEUTIC APPROACH THERAPY TOBACCO TOBACCO CONTROL TOXICOLOGY TREATMENT TRICHOMONAS UNAIDS USE OF CONDOMS VACCINATION VACCINATION PROGRAMS VACCINE VACCINES VIOLENCE WEIGHT LOSS WEIGHT REDUCTION YOUNG ADULTS YOUNG CHILDREN YOUNG PEOPLE YOUNG WOMEN HIV-prevention strategies have yielded only limited success so far in slowing down the AIDS epidemic. This paper examines novel intervention strategies that use incentives to discourage risky sexual behaviors. Widely-adopted conditional cash transfer programs that offer payments conditioning on easily monitored behaviors, such as well-child health care visits, have shown positive impact on health outcomes. Similarly, contingency management approaches have successfully used outcome-based rewards to encourage behaviors that are not easily monitored, such as stopping drug abuse. These strategies have not been used in the sexual domain, so this paper assesses how incentives can be used to reduce risky sexual behavior. After discussing theoretical pathways, it discusses the use of sexual-behavior incentives in the Tanzanian RESPECT trial. There, participants who tested negative for sexually transmitted infections are eligible for outcome-based cash rewards. The trial was well-received in the communities, with high enrollment rates and more than 90 percent of participants viewing the incentives favorably. After one year, 57 percent of enrollees in the "low-value" reward arm stated that the cash rewards "very much" motivated sexual behavioral change, rising to 79 percent in the "high-value" reward arm. Despite its controversial nature, the authors argue for further testing of such incentive-based approaches to encouraging reductions in risky sexual behavior. 2012-03-19T17:29:16Z 2012-03-19T17:29:16Z 2012-02-01 http://www-wds.worldbank.org/external/default/main?menuPK=64187510&pagePK=64193027&piPK=64187937&theSitePK=523679&menuPK=64187510&searchMenuPK=64187283&siteName=WDS&entityID=000158349_20120221132307 http://hdl.handle.net/10986/3259 English Paper is funded by the Knowledge for Change Program (KCP),Policy Research working paper ; no. WPS 5973 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank Publications & Research :: Policy Research Working Paper Africa Africa Sub-Saharan Africa East Africa Tanzania |