Division of Infectious Diseases, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, PA, USA.
Nat Hum Behav. 2022 Oct;6(10):1362-1371. doi: 10.1038/s41562-022-01414-7. Epub 2022 Jul 18.
Many countries have introduced cash transfer programmes as part of their poverty reduction and social protection strategies. These programmes have the potential to overcome drivers of HIV risk behaviours and usage of HIV services, but their overall effects on HIV-related outcomes remain unknown. Here we evaluate the effects of cash transfer programmes covering >5% of the impoverished population on country- and individual-level HIV-related outcomes in 42 countries with generalized epidemics. Cash transfer programmes were associated with a lower probability of sexually transmitted infections among females (odds ratio, 0.67; 95% confidence interval (CI), 0.50-0.91; P = 0.01), a higher probability of recent HIV testing among females (odds ratio, 2.61; 95% CI, 1.15-5.88; P = 0.02) and among males (odds ratio, 3.19; 95% CI, 2.45-4.15; P < 0.001), a reduction in new HIV infections (incidence rate ratio, 0.94; 95% CI, 0.89-0.99; P = 0.03) and delayed improvements in antiretroviral coverage (3%; 95% CI, 0.3-5.7 at year 2; P = 0.03) and AIDS-related deaths (incidence rate ratio, 0.91; 95% CI, 0.83-0.99 at year 2; P = 0.03). Anti-poverty programmes can play a greater role in achieving global targets for HIV prevention and treatment.
许多国家已将现金转移计划纳入其减贫和社会保护战略之中。这些计划有可能克服导致艾滋病毒风险行为和使用艾滋病毒服务的因素,但它们对艾滋病毒相关结果的总体影响尚不清楚。在这里,我们评估了在 42 个存在广泛流行的国家中,覆盖超过 5%贫困人口的现金转移计划对国家和个人层面艾滋病毒相关结果的影响。现金转移计划与女性中性传播感染的可能性降低相关(优势比,0.67;95%置信区间(CI),0.50-0.91;P=0.01),与女性(优势比,2.61;95%CI,1.15-5.88;P=0.02)和男性(优势比,3.19;95%CI,2.45-4.15;P < 0.001)最近接受艾滋病毒检测的可能性增加相关,与新感染艾滋病毒的人数减少相关(发病率比,0.94;95%CI,0.89-0.99;P=0.03),与抗逆转录病毒治疗覆盖率的延迟改善相关(3%;95%CI,0.3-5.7 在第 2 年;P=0.03)和艾滋病相关死亡人数减少相关(发病率比,0.91;95%CI,0.83-0.99 在第 2 年;P=0.03)。反贫困计划可以在实现全球艾滋病毒预防和治疗目标方面发挥更大的作用。