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...

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Bibliographic Details
Main Authors: de Walque, Damien, Dow, William H., Medlin, Carol, Nathan, Rose
Format: Policy Research Working Paper
Language:English
Published: 2012
Subjects:
BS
HIV
SEX
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