Effects of a Lottery Incentive on STI/HIV Incidence Among Female Sex Workers in Tanzania
Outcomes of Rewarding STI Prevention and Control in Tanzania (Respect-2)
Bibliographic Data
| ID | 15336161 |
|---|---|
| Authors | Marianna Balampama (University of Dar es Salaam), Damien De Walque (0000-0003-1592-7602, World Bank Group, corresponding author), William H Dow (0000-0002-4080-1668, University of California, Berkeley), Rebecca Hémono (0000-0003-3753-9344, University of California, Berkeley) |
| Year | 2025 |
| Volume | 29 |
| Issue | 12 |
| Pages | 3852-3865 |
| Publication date | 2025-09-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | AIDS and Behavior (JOURNAL) |
| Journal identifiers | ISSN: 1090-7165 • E-ISSN: 1573-3254 |
| Publisher | Springer Science+Business Media (PUBLISHER • DE) |
| DOI | 10.1007/s10461-025-04822-8 |
| PMID | 40889079 |
| OpenAlex | W4413867841 |
| Language | EN |
| References cited | 23 |
Female sex workers (FSW) are a key population who experience a disproportionately high burden of HIV and sexually transmitted infections (STIs). A growing body of evidence suggests that financial incentives can reduce risky sexual behavior and reduce HIV/STI incidence, however few studies have examined a lottery-based incentive mechanism or been conducted with FSW. We examined the effect of a lottery intervention on combined HIV/HSV2 incidence among FSW. The RESPECT II trial was an unmasked, two-arm, parallel group randomized controlled trial conducted in Dar es Salaam, Tanzania (AEA RCT registry: AEARCTR-0002677). Individuals who were ≥ 18 years of age, HIV-negative, not currently pregnant, exchanged sex for money in the past six months, and living in Dar es Salaam were eligible. Participants were randomized in a 1:1 ratio to the basic test group (control) which included testing and counseling for HIV and biweekly text messages with information on safe sex practices, or to the lottery group, which provided the basic test group intervention plus entry into a weekly lottery with a 100,000 TZS (~ $50 USD) reward offered to ten randomly selected participants, conditional on negative test results for syphilis and trichomonas. The primary outcome was combined HIV/HSV2 incidence after 36 months. Between August 2018-February 2019, 2,489 individuals screened for eligibility and 2,206 were enrolled in the trial and randomized. Participants were followed for up to 36 months; 1089 (49.4%) were lost to follow-up at endline and 1,117 were included in the primary intent to treat analysis (609 lottery, 508 control). At 36 months, there was no effect of the lottery intervention on the incidence of combined HIV/HSV2 (unadjusted RD: - 0.006, 95% CI - 0.05, 0.04; adjusted RD - 0.001, 95% CI - 0.05, 0.05). However, the results may have been affected by disruption from the COVID-19 pandemic, and unexpectedly high study attrition levels made it impossible to statistically rule out possible moderate-sized effects
Developing country · Economic growth · Economics · Environmental health · Family medicine · Health psychology · Human immunodeficiency virus (HIV · Incentive · Incidence (geometry · Lottery · Public health · Socioeconomics · Tanzania · Demography · HIV, Drug Use, Sexual Risk · HIV/AIDS Research and Interventions · Medicine · Nursing · Sex work and related issues
The Demand for, and Impact of, Learning HIV Status
Incentivising safe sex
Training, Wages, and Sample Selection
Global epidemiology of HIV among female sex workers
Burden of HIV among female sex workers in low-income and middle-income countries
Advances in prospect theory
Prospect Theory
The impact of financial incentives on HIV incidence among adolescent girls and young women in Eswatini
Economic vulnerability, violence, and sexual risk factors for HIV among female sex workers in Tijuana, Mexico
Thirty Years of Prospect Theory in Economics
A randomized trial of cash incentives for sexual behavior change among female sex workers in Dar es Salaam
| Citation velocity | historical |
|---|---|
| Highly cited | No |