This project will assess the impact of the Government of Kenya's Cash Transfer for Orphan and Vulnerable Children Program (CT-OVC) on the prevention of HIV. The study has 3 main aims. The first is to continue a unique social experiment initially designed to evaluate the impact of the program on a range of poverty, health and education outcomes among the target group of ultra-poor households with OVC. We will field a 4 year follow-up survey on the same households, approximately 13000 individuals and 6000 OVC, one-third of who were randomized out of the program the remainder who began receiving a cash grant in 2007.
The second aim i s to assess the impact of the program on HIV risk among adolescents, which will be accomplished by expanding the original survey instrument to include new modules on sexual activity and risky behavior among adolescents.
The third aim will assess whether the program has affected time preferences for adults, and how time preferences, subjective risk assessment and risk aversion influence the propensity to engage in choice behavior with long time horizons such as savings, human capital investment and risky sexual activity.

Public Health Relevance

Two-thirds of the estimated 33m people infected with HIV live in sub-Saharan Africa (SSA). Young people (age 15-24) account for nearly half of all new infections in SSA and HIV prevalence is 2 and sometimes 4-5 times higher among young women relative to men. This project examines the impact of the Kenya Cash Transfer for Orphans and Vulnerable Children program on adolescent sexual activity and HIV risk. It is the first study to assess the HIV prevention impact of a large scale government cash transfer program. The rigorous experimental design involving over 2200 households will provide new, robust estimates of the potential for cash transfer programs to reduce HIV transmission among young people in SSA.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
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Behavioral and Social Science Approaches to Preventing HIV/AIDS Study Section (BSPH)
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Kamath, Susannah M Allison
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University of North Carolina Chapel Hill
Schools of Arts and Sciences
Chapel Hill
United States
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Huang, Carolyn; Singh, Kavita; Handa, Sudhanshu et al. (2017) Investments in children's health and the Kenyan cash transfer for orphans and vulnerable children: evidence from an unconditional cash transfer scheme. Health Policy Plan 32:943-955
Handa, Sudhanshu; Palermo, Tia; Rosenberg, Molly et al. (2017) How does a national poverty programme influence sexual debut among Kenyan adolescents? Glob Public Health 12:617-638
Handa, Sudhanshu; Martorano, Bruno; Halpern, Carolyn et al. (2016) Time Discounting and Credit Market Access in a Large-Scale Cash Transfer Programme. J Afr Econ 25:367-387
Kilburn, Kelly; Thirumurthy, Harsha; Halpern, Carolyn Tucker et al. (2016) Effects of a Large-Scale Unconditional Cash Transfer Program on Mental Health Outcomes of Young People in Kenya. J Adolesc Health 58:223-9
Handa, Sudhanshu; Peterman, Amber; Huang, Carolyn et al. (2015) Impact of the Kenya Cash Transfer for Orphans and Vulnerable Children on early pregnancy and marriage of adolescent girls. Soc Sci Med 141:36-45
Handa, Sudhanshu; Halpern, Carolyn Tucker; Pettifor, Audrey et al. (2014) The government of Kenya's cash transfer program reduces the risk of sexual debut among young people age 15-25. PLoS One 9:e85473
Rosenberg, Molly; Pettifor, Audrey; Thirumurthy, Harsha et al. (2014) The impact of a national poverty reduction program on the characteristics of sex partners among Kenyan adolescents. AIDS Behav 18:311-6