A savings intervention to reduce men's engagement in HIV risk behaviors

减少男性艾滋病毒危险行为的储蓄干预措施

• 批准号: 10258585
• 负责人: HARSHA THIRUMURTHY
• 金额: $ 70.83万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-01 至 2026-03-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10258585
• 关键词: AIDS prevention; Address; Africa South of the Sahara; Age; Alcohol abuse; Alcohol consumption; Alcohols; Automobile Driving; Behavior; Behavior Therapy; Behavioral; Behavioral Mechanisms; Chlamydia; Communicable Diseases; Complement; Control Groups; Data; Decision Making; Eastern Africa; Economics; Education; Effectiveness; Effectiveness of Interventions; Equilibrium; Expenditure; Female; Future; Gambling; Goals; Gonorrhea; HIV; HIV risk; Health; Health Services Research; Health behavior; Health education; Heavy Drinking; High Prevalence; Human Herpesvirus 2; Incentives; Incidence; Income; Individual; Intervention; Interview; Investments; Kenya; Link; Longterm Follow-up; Low income; Male Circumcision; Measures; Medical; Multiple Partners; Outcome; Participant; Perception; Periodicity; Pilot Projects; Policies; Prize; Public Health; Qualitative Methods; Randomized; Randomized Controlled Trials; Research Personnel; Rewards; Risk; Risk Behaviors; Role; Sampling; Savings; Security; Services; Sexually Transmitted Diseases; Southern Africa; Surveys; Syphilis; Testing; Training; Unsafe Sex; Vocational Education; Woman; Women' s Health; antiretroviral therapy; base; behavior change; behavior influence; design; discounting; economic behavior; economic outcome; empowerment; female sex worker; financial incentive; financial literacy; follow-up; group intervention; health economics; high risk; high risk men; high risk sexual behavior; improved; infection burden; infection risk; innovation; interest; low income country; men; pre-exposure prophylaxis; programs; psychologic; randomized trial; response; scale up; sex; sexual HIV transmission; sexual relationship

Project Abstract In much of eastern and southern Africa, the incidence of HIV and other sexually transmitted infections (STIs) remains high despite the scale-up of promising biomedical and behavioral interventions. Recent studies have documented the crucial role of transactional sex – the exchange of money, material support or goods in age- disparate, sexual relationships – and heavy alcohol use in driving HIV/STI incidence and influencing men's and women's health outcomes. Existing policy responses to this challenge have largely focused on women, with various interventions to reduce women's engagement in transactional sex such as education subsidies, vocational training, and cash transfers for economic empowerment. However, the effectiveness of these interventions has been hindered by the relative lack of programs that target men's behavior. There is a vital need for interventions that can reduce men's engagement in risky behaviors that increase HIV/STI risk. This project will test an innovative, theoretically-motivated economic intervention to reduce men's engagement in transactional sex and other risky behaviors. Leveraging innovations in mobile financial services and research on savings behavior in low-income countries, our intervention will motivate high-risk, income-earning men in Kenya to reduce their spending on risky behaviors and instead save their disposable income in local bank accounts. These bank accounts will include (a) additional incentives to save in the form of lottery-based rewards linked to amounts saved, (b) opportunities to develop savings goals, and (c) periodic reminders about the incentives and goals. Through a direct economic mechanism (incentives to shift expenditures from the present to the future) and a psychological mechanism (increasing future orientation), this intervention can generate significant behavior change and improve health outcomes. We will conduct a randomized controlled trial among high-risk men to determine effects of the savings intervention on their health and economic outcomes. Specific aims of the project are as follows. Aim 1: Determine the impact of the savings intervention on incidence of HIV and other STIs. Aim 2: Determine intervention impacts on savings and expenditures as well as risky health behaviors. Aim 3: Quantitatively and qualitatively assess mechanisms of behavior change among participants and among a sample of female partners. By testing an intervention to promote forward- looking behavior and reduce the risk of acquiring HIV and other STIs in a high HIV/STI burden setting, this project has high potential for scientific and public health impact.

项目摘要 在东部和南部非洲的大部分地区，艾滋病毒和其他性传播感染事件（ETI） 尽管有希望的生物医学和行为干预措施扩大了范围，但仍保持很高。最近的研究 记录了交易性别的关键作用 - 年龄在年龄中的货币，物质支持或商品的交换 - 不同 妇女的健康成果。现有对这一挑战的政策回应主要集中在女性上， 各种干预措施以减少妇女从事交易性别的参与，例如教育补贴， 职业培训和经济授权的现金转移。但是，这些的有效性 相对缺乏针对男性行为的程序的相对缺乏，干预措施受到了阻碍。有一个重要 需要减少男性参与风险行为的干预措施，从而增加HIV/STI风险。 该项目将测试一种创新的，理论上动机的经济干预，以减少男性参与 在交易性行为和其他风险行为中。利用移动金融服务的创新和 关于低收入国家储蓄行为的研究，我们的干预将激发高风险，收入收入 肯尼亚的男人以减少对风险行为的支出，而是在当地节省处置收入 银行帐户。这些银行帐户将包括（a）以基于彩票的形式节省的其他激励措施 与节省金额相关的奖励，（b）建立储蓄目标的机会，以及（c）定期提醒 激励和目标。通过直接的经济机制（激励支出从 呈现未来）和一种心理机制（不断提高未来取向），这种干预可以 产生重大的行为改变并改善健康结果。我们将进行随机控制 高风险男人之间的试验，以确定储蓄干预对其健康和经济的影响 结果。 该项目的具体目标如下。目标1：确定储蓄干预对 艾滋病毒和其他性传播感染的发病率。目标2：确定干预对储蓄和支出的影响 作为风险的健康行为。目标3：定量和定性评估行为改变机制 在参与者和女性伴侣样本中。通过测试干预措施以促进前进 - 在高艾滋病毒/STI Burnen环境中，看上去的行为并降低了获得艾滋病毒和其他性传播感染的风险， 项目对科学和公共卫生影响具有很高的潜力。