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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).
The Friends of AIDS Foundation is
dedicated to enhancing the quality of life for HIV positive individuals and
empowering people to make healthy choices to prevent the spread of the HIV
virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
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