Analysis of the impact of cash transfer programs on HIV risk behaviors in Kenya

Abstract

Background This paper investigates the impact of Kenyan unconditional cash transfer programs on a range of HIV risk indicators, including transactional sex, sexual concurrency, knowledge of HIV, and HIV testing. Previous research on cash transfers in similar contexts suggests that the provision of cash transfers can be a potent method to bolster HIV prevention efforts. We hypothesized that as a result of receiving cash transfers from the government, individuals will have increased contact with social services, which can provide them with critical health education that will motivate them to modify their HIV risk behaviors. Methods We used data from the latest Kenya Demographic and Health Survey (KDHS), which contained 12,800 unique responses from individuals between the ages of 15 and 54. We compared the prevalence of various HIV risk indicators and demographic covariates between those who received cash transfers and those who did not using unequal variances t-tests and chi-square tests. We estimated the average treatment effect on the treated (ATT) using propensity score matching. Results Notably, individuals who received any cash transfer were less likely to have paid for sex in the past 12 months (ATT: -0.024, P=0.023), more likely to know of a place to get tested for HIV (ATT: 0.022, P=0.030), and more likely to have used a condom during sex with their most recent partner (ATT: 0.045, P=0.038). However, cash transfer recipients were more likely to have a sexual partner 10 or more years older than themselves (ATT: 0.102, P<0.001), less likely to have comprehensive HIV knowledge (ATT: -0.118, P<0.001), and more likely to have been tested for HIV two or more years ago (ATT: 0.052, P=0.028). Conclusions Based on our analysis of nationally representative data, we conclude that the receipt of unconditional cash transfers is associated with the reduction of some HIV risk indicators in Kenya.