Schooling, Income, and HIV Risk in Malawi

Not Applicable

Active, not recruiting

• Conditions: Schooling; Conditional Cash Transfers; Unconditional Cash Transfers; HIV
• Interventions: Behavioral: Zomba Cash Transfer Program

• Registration Number: NCT01333826
• Lead Sponsor: George Washington University

Brief Summary

This study is designed to evaluate a two-year randomized intervention in Malawi that provides cash transfers to current schoolgirls (and young women who have recently dropped out of school) to stay in (and return to) school in order to understand the possible effects of such programs on the sexual behavior of the beneficiaries and their subsequent HIV risk.

Detailed Description

Motivation:

Education has been suggested as a "social vaccine" to prevent the spread of HIV (Jukes, Simmons, and Bundy, 2008), but almost all of the evidence we have on the link between school attendance (or attainment) and the risk of HIV infection comes from cross-sectional studies. Furthermore, the role of income (especially that of women's poverty) has been hypothesized as a significant factor in the spread of HIV in SSA, but again there is no credible evidence showing a causal link between income and HIV risk. A randomized intervention, such as the one proposed here, that provides randomly varied amounts of cash transfers to young individuals and their guardians is the perfect setting to examine the possible existence of such causal relationships.

Objectives:

The objective of the proposed study here is to provide credible evidence on issues about which we still know very little. Specifically, the main questions the study will try to answer are the following:

1. Are the observed effects of a CCT associated with the transfer or the conditionality imposed on the recipient?

2. Do the outcomes of interest improve with increased benefit levels set by the program?

3. Do CCT programs for schooling have any positive health impacts, including prevention of STIs such as HIV/AIDS among young people?

Study Timeline

• Study Start: 2007-09
• Study First Submitted: 2011-04-11
• Study First Submitted QC: 2011-04-11
• Study First Posted: 2011-04-12
• Primary Completion: 2012-09
• Status Verified: 2024-11
• Last Update Submitted: 2024-11-12
• Last Update Posted: 2024-11-13
• Study Completion: 2025-05

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: Female
• Target Recruitment: 3796

Inclusion Criteria

• female
• 13-22 years old
• never married

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Conditional Cash Transfer	Zomba Cash Transfer Program	Monthly cash transfers given to households with school aged girls conditional on regular school attendance (80%). Transfer amounts randomized within this arm.
Unconditional cash transfers	Zomba Cash Transfer Program	Monthly cash transfers given to households with school aged girls with no strings attached. Transfer amounts randomized within this arm.

Primary Outcome Measures

Name	Time	Method
Schooling	12 months/24 months	school enrollment
Sexually Transmitted Infections	18 months	HIV prevalence HSV-2 prevalence

Secondary Outcome Measures

Name	Time	Method
sexual behavior	12 months/ 24 months	new sexual debut unprotected sexual intercourse weekly sexual intercourse had a sexual partner 25 or older
HIV Awareness	12 months/24 months	ever tested for HIV received health training on HIV HIV knowledge
Sexually Transmitted Infections	18 months	syphilis
Marriage and fertility	12 months/24 months	ever married currently pregnant

Trial Locations

Locations (1)

Zomba District, Malawi; 🇲🇼 Zomba, Malawi