Science Daily (02.04.13)
Aids Weekly Plus
Public health researchers investigated whether a cash transfer program in which governments pay citizens to practice societally beneficial behaviors could be used to curtail HIV risk behaviors among gay men and male sex workers in Mexico City. According to Omar Galárraga, assistant professor of health services policy and practice at Mexico’s Institute for Public Health, the goal is to reduce the number of sex partners and increase the use of condoms—to increase safe sex. Since these behaviors cannot be observed, a reduction in the numbers of sexually transmitted infections (STIs) is correlated with the goal. This program would prevent HIV transmission and save money. The Mexican government’s healthcare policy offers universal access to HIV treatment, which costs $5,000 to $7,000 a year.
The researchers recruited and trained young men who had sex with men in Mexico City to present surveys to their peers in discotheques, metro stations, bars, and streets in the red-light district. The interviewers explained that they were doing a survey about HIV risk behaviors and ways to reduce infection. The participants were given a handheld computer with software that administered the confidential and anonymous 40-minute survey. The software also took participants through a bidding and bargaining process, in which they declared the level of payment they were willing to accept for their involvement in either one or both of two programs. The programs consisted of monthly talks about HIV prevention and STI testing, and quarterly check-ins to verify a pledge of remaining STI free.
Findings show that more than three-quarters of the participants were willing to attend monthly prevention talks, get tested for STIs, and pledge to stay STI free with testing to verify their status if paid $288 a year. The male sex workers agreed to the same at a lower payment of $156 a year. Approximately 9 percent of the men would not participate at any price. These individuals tended to be more educated and wealthier. As a result of the findings, researchers have implemented a small pilot conditional cash transfer program with approximately 200 male sex workers and gay men with more than 10 partners a month.
The full report, “Willingness-to-Accept Reductions in HIV Risks: Conditional Economic Incentives in Mexico,” was published online in the European Journal of Health Economics (2013; doi: 10.1007/s10198-012-0447-y).