Dow, William H.de Walque, DamienMedlin, CarolNathan, Rose2012-03-192012-03-192012-02-01https://hdl.handle.net/10986/3259HIV-prevention strategies have yielded only limited success so far in slowing down the AIDS epidemic. This paper examines novel intervention strategies that use incentives to discourage risky sexual behaviors. Widely-adopted conditional cash transfer programs that offer payments conditioning on easily monitored behaviors, such as well-child health care visits, have shown positive impact on health outcomes. Similarly, contingency management approaches have successfully used outcome-based rewards to encourage behaviors that are not easily monitored, such as stopping drug abuse. These strategies have not been used in the sexual domain, so this paper assesses how incentives can be used to reduce risky sexual behavior. After discussing theoretical pathways, it discusses the use of sexual-behavior incentives in the Tanzanian RESPECT trial. There, participants who tested negative for sexually transmitted infections are eligible for outcome-based cash rewards. The trial was well-received in the communities, with high enrollment rates and more than 90 percent of participants viewing the incentives favorably. After one year, 57 percent of enrollees in the "low-value" reward arm stated that the cash rewards "very much" motivated sexual behavioral change, rising to 79 percent in the "high-value" reward arm. Despite its controversial nature, the authors argue for further testing of such incentive-based approaches to encouraging reductions in risky sexual behavior.CC BY 3.0 IGOABSTINENCEADDICTIONADDICTIVE BEHAVIORSADOLESCENTADOLESCENT GIRLADULT PREVALENCEADULT PREVALENCE RATEAGEDAIDS EPIDEMICAIDS PANDEMICAIDS PATIENTAIDS PREVENTIONAIDS VACCINEALCOHOLALCOHOL ABUSEALCOHOL DEPENDENCEALCOHOL USEANAL SEXANTENATAL CAREANTIVIRALSBEHAVIOR CHANGEBEHAVIORAL CHANGEBEHAVIORAL CHANGESBLOOD PRESSUREBLOOD TESTSBSCHILD CARECHILD HEALTHCHILD HEALTH CARECHLAMYDIACIRCUMCISIONCLINICAL PSYCHOLOGYCLINICAL TRIALSCLINICSCOCAINECOMMERCIAL SEXCOMPLICATIONSCONDOMCONDOM PROMOTIONCONDOM USECONDOMSCONTRACEPTIONCONTRACEPTIVE PREVALENCECOST EFFECTIVENESSCOUNSELING INTERVENTIONDEVELOPING COUNTRIESDEVELOPMENT POLICYDEVELOPMENTAL PSYCHOLOGYDIAGNOSISDISEASEDISEASE CONTROLDISEASE TRANSMISSIONDRUG ABUSEDRUG USEDRUGSEARLY YEARSEDUCATIONAL SERVICESETHICAL CONSIDERATIONSFAMILIESFAMILY PLANNINGFEMALESFINANCIAL CONSTRAINTSFOCUS GROUP DISCUSSIONSGLOBAL AIDS EPIDEMICGLOBAL HEALTHGONORRHEAHEALTH CAREHEALTH CARE SERVICESHEALTH CONSEQUENCESHEALTH EDUCATIONHEALTH IMPACTHEALTH INTERVENTIONSHEALTH OUTCOMESHEALTH SERVICESHEALTH SYSTEMSHIGH RISK GROUPSHIVHIV INFECTIONSHIV POSITIVEHIV PREVENTIONHIV TESTINGHIV TRANSMISSIONHIV/AIDSHUMAN CAPITALHUMAN DEVELOPMENTILLNESSIMMUNIZATIONIMPACT ON HEALTHINFECTIONINFECTION PREVENTIONINFORMED CONSENTINTERNATIONAL FAMILY PLANNINGINTERNATIONAL FAMILY PLANNING PERSPECTIVESINTERVENTIONJOURNAL OF MEDICINELACK OF INFORMATIONLOW PREVALENCEMALE CIRCUMCISIONMALE SEXMALE SEX WORKERSMASS COMMUNICATIONMEDICAL RESEARCHMEDICATIONMEDICINESMETHADONEMETHADONE PATIENTSMICROBICIDESMOTHERMOTHER-TO-CHILDMOTHER-TO-CHILD TRANSMISSIONMULTIPLE PARTNERSNEGATIVE EFFECTSNUCLEIC ACIDNUMBER OF NEW INFECTIONSNURSENUTRITIONNUTRITIONAL STATUSOBESITYOCCUPATIONAL MEDICINEOVERWEIGHTPATIENTPATIENT CAREPATIENTSPEER PRESSUREPOLICY DISCUSSIONSPOLICY RESEARCHPOLICY RESEARCH WORKING PAPERPOOR FAMILIESPOPULATION AND DEVELOPMENTPOPULATION REFERENCE BUREAUPREGNANCIESPREGNANCYPRENATAL CAREPREVALENCE OF SYPHILISPREVALENCE RATEPREVENTION COUNSELINGPREVENTION EFFORTSPREVENTION METHODSPREVENTION STRATEGIESPREVENTIVE HEALTHPREVENTIVE MEDICINEPROGRESSPSYCHIATRYPSYCHOLOGISTSPSYCHOPHARMACOLOGYPUBLIC HEALTHPUBLIC SERVICESRANDOMIZED CONTROLLED TRIALSREPRODUCTIVE HEALTHREPRODUCTIVE HEALTH SERVICESRESPECTRISK BEHAVIORRISK BEHAVIORSRISK FACTORSRISK GROUPSRISK REDUCTIONRISK REDUCTION STRATEGIESRISKY BEHAVIORRISKY BEHAVIORSRISKY SEXRISKY SEXUAL BEHAVIORRISKY SEXUAL BEHAVIORSSAFE SEXSCHOOLSSERVICE PROVIDERSSEXSEX WORKSEX WORKERSSEXUAL ACTIVITYSEXUAL BEHAVIOURSEXUAL CONTACTSEXUAL ENCOUNTERSSEXUAL HEALTHSEXUAL INTERCOURSESEXUAL PARTNERSSEXUAL PRACTICESSEXUAL RELATIONSHIPSEXUALLY TRANSMITTED INFECTIONSEXUALLY TRANSMITTED INFECTIONSSMOKERSSMOKINGSMOKING CESSATIONSOCIAL NORMSSOCIAL STATUSSOCIAL SUPPORTSPOUSESPOUSESSTDSSTERILIZATIONSTISSUBSTANCE ABUSESUBSTANCE ABUSE TREATMENTSYPHILISTEENTEEN PREGNANCYTHERAPEUTIC APPROACHTHERAPYTOBACCOTOBACCO CONTROLTOXICOLOGYTREATMENTTRICHOMONASUNAIDSUSE OF CONDOMSVACCINATIONVACCINATION PROGRAMSVACCINEVACCINESVIOLENCEWEIGHT LOSSWEIGHT REDUCTIONYOUNG ADULTSYOUNG CHILDRENYOUNG PEOPLEYOUNG WOMENWorld Bank10.1596/1813-9450-5973