AIDS and Behavior

, Volume 23, Issue 5, pp 1178–1194 | Cite as

Cash Transfers, Young Women’s Economic Well-Being, and HIV Risk: Evidence from HPTN 068

  • Kelly KilburnEmail author
  • James P. Hughes
  • Catherine MacPhail
  • Ryan G. Wagner
  • F. Xavier Gómez-Olivé
  • Kathleen Kahn
  • Audrey Pettifor
Original Paper


Despite the large interest in economic interventions to reduce HIV risk, little research has been done to show whether there are economic gains of these interventions for younger women and what intermediary role economic resources play in changing participants’ sexual behavior. This paper contributes to this gap by examining the impacts of a conditional cash transfer (CCT) for young women in South Africa on young women’s economic resources and the extent to which they play a role in young women’s health and behavior. We used data from HIV Prevention Trials Network 068 study, which provided transfers to young women (in addition to their parents) conditional on the young woman attending at least 80% of school days in the previous month. We found that the CCT increased young women’s economic wellbeing in terms of having savings, spending money, being unindebted, and food secure. We also investigated heterogeneous effects of the program by household economic status at baseline because the program was not specifically poverty targeted and found that the results were driven by young women from the poorest families. From these results, we examined heterogeneity by baseline poverty for other outcomes related to HIV risk including sexual behavior and psychosocial well-being. We found psychosocial well-being benefits in young women from the poorest families and that economic wellbeing gains explained much these impacts.


Adolescent girls and young women South Africa Economic empowerment Cash transfers Psychosocial well-being 



Funding support for the HPTN was provided by the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute of Mental Health (NIMH), and the National Institute on Drug Abuse (NIDA) of the National Institutes of Health (NIH; Award Numbers UM1AI068619 [HPTN Leadership and Operations Center], UM1AI068617 [HPTN Statistical and Data Management Center], and UM1AI068613 [HPTN Laboratory Center]. The study was also funded under R01MH110186, R01MH087118, and R24 HD050924 to the Carolina Population Center. Research reported in this publication was also supported by the NIAID of the NIH [Award Number T32AI007001]. Additional funding was provided by the Division of Intramural Research, NIAID, and NIH. The Agincourt Health and Socio-Demographic Surveillance System is supported by the University of the Witwatersrand, the Medical Research Council, South Africa and the Wellcome Trust, UK (Grants 058893/Z/99/A; 069683/Z/02/Z; 085477/Z/08/Z; and 085477/B/08/Z).

Compliance with Ethical Standards

Conflict of interest

The 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.


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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Carolina Population CenterUniversity of North CarolinaChapel HillUSA
  2. 2.Department of Global Health, School of Public HealthGeorge Washington UniversityWashingtonUSA
  3. 3.Department of Biostatistics, School of Public HealthUniversity of WashingtonSeattleUSA
  4. 4.Statistical Center for HIV/AIDS Research and Prevention (SCHARP)SeattleUSA
  5. 5.School of Health and SocietyUniversity of WollongongWollongongAustralia
  6. 6.Wits Reproductive Health and HIV InstituteUniversity of the WitwatersrandJohannesburgSouth Africa
  7. 7.MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
  8. 8.Umeå Centre for Global Health Research, Division of Epidemiology and Global Health, Department of Public Health and Clinical MedicineUmeå UniversityUmeåSweden
  9. 9.INDEPTH NetworkAccraGhana
  10. 10.Department of EpidemiologyUniversity of North CarolinaChapel HillUSA

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