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

Author

Listed:
  • Mark E. McGovern
  • Kobus Herbst
  • Frank Tanser
  • Tinofa Mutevedzi
  • David Canning
  • Dickman Gareta
  • Deenan Pillay
  • Till Bärnighausen

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.

Suggested Citation

  • Mark E. McGovern & Kobus Herbst & Frank Tanser & Tinofa Mutevedzi & David Canning & Dickman Gareta & Deenan Pillay & Till Bärnighausen, 2016. "Do Gifts Increase Consent to Home-based HIV Testing? A Difference-in-Differences Study in Rural KwaZulu-Natal, South Africa," CHaRMS Working Papers 16-05, Centre for HeAlth Research at the Management School (CHaRMS).
    • Handle: RePEc:qub:charms:1605
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    Cited by:

    1. Declan French & Jonathan Brink & Till Bärnighausen, 2019. "Early HIV treatment and labour outcomes: A case study of mining workers in South Africa," Health Economics, John Wiley & Sons, Ltd., vol. 28(2), pages 204-218, February.
    2. McGovern, Mark E. & Rokicki, Slawa & Reichman, Nancy E., 2022. "Maternal depression and economic well-being: A quasi-experimental approach," Social Science & Medicine, Elsevier, vol. 305(C).
    3. Slawa Rokicki & Jessica Cohen & Gunther Fink & Joshua Salomon & Mary Beth Landrum, 2018. "Inference with difference-in-differences with a small number of groups: a review, simulation study and empirical application using SHARE data," CHaRMS Working Papers 18-01, Centre for HeAlth Research at the Management School (CHaRMS).
    4. McGovern, Mark E. & Canning, David & Bärnighausen, Till, 2018. "Accounting for non-response bias using participation incentives and survey design: An application using gift vouchers," Economics Letters, Elsevier, vol. 171(C), pages 239-244.
    5. Mark McGovern & David Canning & Till Bärnighausen, 2018. "Accounting for Non-Response Bias using Participation Incentives and Survey Design," CHaRMS Working Papers 18-02, Centre for HeAlth Research at the Management School (CHaRMS).
    6. Tshifhiwa Muravha & Christopher J Hoffmann & Claire Botha & Wellington Maruma & Salome Charalambous & Candice M Chetty-Makkan, 2021. "Exploring perceptions of low risk behaviour and drivers to test for HIV among South African youth," PLOS ONE, Public Library of Science, vol. 16(1), pages 1-15, January.

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    More about this item

    Keywords

    Gift-voucher Intervention; Incentives; Difference-in-Differences; Home-based HIV Testing; South Africa;
    All these keywords.

    JEL classification:

    • J10 - Labor and Demographic Economics - - Demographic Economics - - - General
    • I10 - Health, Education, and Welfare - - Health - - - General

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