Carolina Population Center and Department of Public Policy, University of North Carolina, Chapel Hill, North Carolina, United States of America.
Carolina Population Center and Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America.
PLoS One. 2014 Jan 15;9(1):e85473. doi: 10.1371/journal.pone.0085473. eCollection 2014.
The aim of this study is to assess whether the Government of Kenya's Cash Transfer for Orphans and Vulnerable Children (Kenya CT-OVC) can reduce the risk of HIV among young people by postponing sexual debut. The program provides an unconditional transfer of US$20 per month directly to the main caregiver in the household. An evaluation of the program was implemented in 2007-2009 in seven districts. Fourteen Locations were randomly assigned to receive the program and fourteen were assigned to a control arm. A sample of households was enrolled in the evaluation in 2007. We revisited these households in 2011 and collected information on sexual activity among individuals between 15-25 years of age. We used logistic regression, adjusted for the respondent's age, sex and relationship to caregiver, the age, sex and schooling of the caregiver and whether or not the household lived in Nairobi at baseline, to compare rates of sexual debut among young people living in program households with those living in control households who had not yet entered the program. Our results, adjusted for these covariates, show that the program reduced the odds of sexual debut by 31 percent. There were no statistically significant effects on secondary outcomes of behavioral risk such as condom use, number of partners and transactional sex. Since the CT-OVC provides cash to the caregiver and not to the child, and there are no explicit conditions associated with receipt, these impacts are indirect, and may have been achieved by keeping young people in school. Our results suggest that large-scale national social cash transfer programs with poverty alleviation objectives may have potential positive spillover benefits in terms of reducing HIV risk among young people in Eastern and Southern Africa.
本研究旨在评估肯尼亚政府的“孤儿和弱势儿童现金转移（肯尼亚 CT-OVC）”项目是否可以通过推迟年轻人的性初夜来降低艾滋病病毒的风险。该项目每月向家庭中的主要照顾者无条件发放 20 美元的现金转移支付。该项目的评估于 2007-2009 年在七个地区实施。14 个地点被随机分配接受该项目，14 个地点被分配到对照组。2007 年对这些家庭进行了抽样评估。我们在 2011 年回访了这些家庭，并收集了 15-25 岁个体的性行为信息。我们使用逻辑回归模型，调整了受访者的年龄、性别和与照顾者的关系、照顾者的年龄、性别和受教育程度以及家庭在基线时是否居住在内罗毕，来比较项目家庭中年轻人和尚未进入项目的对照组家庭中年轻人的性初体验率。在调整这些协变量后，我们的结果表明，该项目使年轻人的性初体验率降低了 31%。项目对行为风险的次要结果（如避孕套使用、性伴侣数量和交易性性行为）没有统计学上的显著影响。由于 CT-OVC 将现金发放给照顾者而不是儿童，并且没有与领取现金相关的明确条件，因此这些影响是间接的，可能是通过让年轻人留在学校来实现的。我们的结果表明，具有扶贫目标的大规模国家社会现金转移项目可能对减少东非和南非年轻人的艾滋病病毒风险具有潜在的积极溢出效益。
