HPTN 068: A Randomized Control Trial of a Conditional Cash Transfer to Reduce HIV Infection in Young Women in South Africa—Study Design and Baseline Results

Abstract

Young women in South Africa are at high risk for HIV infection. Cash transfers offer promise to reduce HIV risk. We present the design and baseline results from HPTN 068, a phase III, individually randomized trial to assess the effect of a conditional cash transfer on HIV acquisition among South African young women. A total of 2533 young women were randomized to receive a monthly cash transfer conditional on school attendance or to a control group. A number of individual-, partner-, household- and school-level factors were associated with HIV and HSV-2 infection. After adjusting for age, all levels were associated with an increased odds of HIV infection with partner-level factors conveying the strongest association (aOR 3.05 95 % CI 1.84–5.06). Interventions like cash transfers that address structural factors such as schooling and poverty have the potential to reduce HIV risk in young women in South Africa.

Effect of Schooling on Age-Disparate Relationships and Number of Sexual Partners Among Young Women in Rural South Africa Enrolled in HPTN 068

“…15 The study included 2,533 young women aged 13-20 years who were registered in high school in grades 8-11 at enrollment within the rural Bushbuckridge sub-district of Mpumalanga province, South Africa. Potential participants were excluded if they were pregnant or married at enrollment, or if they did not have a parent or guardian in the household.…”

Relationship between children’s cognitions and later educational progress in rural South Africa: a longitudinal study

“…A sensitivity analysis suggests that the 81 females who were included in the conditional cash transfer RCT23 did not systematically differ from the other females in the sample.…”

“…Between 2011 and 2014, researchers examined the impact of a 3-year conditional cash transfer programme for females aged 13–20 years on subsequent HIV status 23. Participants in the intervention arm were paid R300 (US$30) per month if they attended at least 80% of school days in a month.…”

“…The HIV status of the participants in both the control and intervention arms was assessed at enrolment and annually for up to 3 years. The trial found that neither school attendance nor new HIV infections differed between control and intervention groups, but that school attendance was very high (about 95%) in both arms 23. We conducted a sensitivity analysis to examine if participation in the trial could account for any association between mental health and school progress.…”

Weak HIV Antibody Responses in Perinatally Infected Young Adults

“…For example, among the young women enrolled in the HPTN 068 trial (Pettifor et al, 2016), 1.5% of non-sexually active 13–14 year old girls were HIV positive. In this trial, 38/81 young women who were HIV positive denied any sexual activity.…”