Give a man a fish, he will eat for a day. But give people money unconditionally, and you’ll reduce the rate of new HIV infections and AIDS-related deaths. Cash transfer programs have become popular in low- and middle-income countries for their potential to provide social safety nets and reduce poverty, but their primary objective is not to improve public health.
This is why the conclusions of a new study, published on Monday in Nature Human behavior, are so encouraging to infectious disease scientists. Researchers at the University of Pennsylvania analyzed more than 20 years of data from cash transfer programs run in 42 different countries, which were not specifically developed to impact infection, testing and treatment HIV and other STIs.
Aaron Richterman, an infectious disease researcher at the University of Pennsylvania and lead author of the new study, told The Daily Beast that he and his co-author distinguish these large-scale programs from smaller-scale experimental programs, the latter of which have yielded mixed results. reduce HIV-related outcomes. Such studies may overlook two “ripple effects”: cash recipients may share the cash with their families, and infectious disease rates depend on the behaviors of an entire community, not just individuals. a subset of enrolled study subjects.
Getting tested for HIV and getting effective treatment is “like a double whammy,” Richterman said. “It improves outcomes for that individual person, but it also improves outcomes for the community in terms of reducing transmissions to other people.”
Richterman emphasized that the cash programs evaluated in the study were not intended to control HIV or other STIs, but the results nonetheless demonstrate their utility in doing so. The programs corresponded to an immediate 6% reduction in the risk of a new HIV infection that continued up to a decade later. The risk of AIDS-related death decreased by 9% and HIV treatment coverage increased by 3% after a short delay.
“There are both economic and psychological pathways” through which programs can work, Richterman said. Money can reduce barriers to getting tested and buying drugs, but it can also give people more mental leeway to focus on long-term decision-making. Additionally, in sub-Saharan Africa, cash transfers can reduce the rate of transactional sex, which is a major risk factor for HIV transmission among young women.
Most HIV reduction programs today focus on strictly public health measures, Richterman said, such as encouraging people at high risk to take pre-exposure prophylaxis (PrEP) or get tested. for HIV and other STIs. This study shows that “we should also be thinking about a wider range of interventions, such as basic income”, he added.
It is not too much of a stretch to speculate on these results in the context of the universal basic income plans offered in the United States. Richterman conducted another study that linked more generous SNAP benefits to reduced HIV rates. Even though the United States is considered a high-income country, his research found that the main benefits of cash transfers seem to hold.
“It’s a country that has a lot of inequality,” Richterman said. “It’s very plausible to start thinking about how things like basic income could be used to end the HIV epidemic in the United States”