Do Gifts Increase Consent to Home-based HIV Testing? A Difference-in-Differences Study in Rural KwaZulu-Natal, South Africa

Mark McGovern, Kobus Herbst, Frank Tanser, Tinofa Mutevedzi, David Canning, Dickman Gareta, Deenan Pillay and Till Bärnighausen

No 16-05, CHaRMS Working Papers from Centre for HeAlth Research at the Management School (CHaRMS)

Abstract: Despite the importance of HIV testing for controlling the HIV epidemic, testing rates remain low. Efforts to scale up testing coverage and frequency in hard-to-reach and at-risk populations commonly focus on home-based HIV testing. This study evaluates the effect of a gift (a US $5 food voucher for families) on consent rates for home-based HIV testing. We use data on 18,478 individuals (6,418 men and 12,060 women) who were successfully contacted to participate in the 2009 and 2010 population-based HIV surveillance carried out by the Wellcome Trust's Africa Health Research Institute in rural KwaZulu-Natal, South Africa. Of 18,478 potential participants contacted in both years, 35% (6,518) consented to test in 2009, and 41% (7,533) consented to test in 2010. Our quasi-experimental difference-in-differences approach controls for unobserved confounding in estimating the causal effect of the intervention on HIV-testing consent rates. Allocation of the gift to a family in 2010 increased the probability of family members consenting to test in the same year by 25 percentage points [95% confidence interval (CI) 21--30 percentage points; P less than 0.001]. The intervention effect persisted, slightly attenuated, in the year following the intervention (2011). In HIV hyperendemic settings, a gift can be highly effective at increasing consent rates for home-based HIV testing. Given the importance of HIV testing for treatment uptake and individual health, as well as for HIV treatment-as-prevention strategies and for monitoring the population impact of the HIV response, gifts should be considered as a supportive intervention for HIV-testing initiatives where consent rates have been low.

Keywords: Gift-voucher Intervention; Incentives; Difference-in-Differences; Home-based HIV Testing; South Africa (search for similar items in EconPapers)
JEL-codes: I10 J10 (search for similar items in EconPapers)
Pages: 30 pages
Date: 2016-12
New Economics Papers: this item is included in nep-dev and nep-hea
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Citations: View citations in EconPapers (6)

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