Do gifts increase consent to home-based HIV testing? A difference-in-differences study in rural KwaZulu-Natal, South Africa

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

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)
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Abstract

Background 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 food voucher for families, worth US$ 5) on consent rates for home-based HIV testing.
Methods We use data on 18,478 men and women who participated in the 2009 and 2010 population-based HIV surveillance carried out by the Wellcome Trust Africa Centre for Health and Population Studies in rural KwaZulu-Natal, South Africa. Our quasi-experimental difference-in-differences approach controls for unobserved confounding in estimating the causal effect of the intervention on HIV testing consent rates.
Results Allocation of the gift to a family in 2010 increased the probability of family members consenting to test in 2010 by 25 percentage points (95% CI 21-30; p<0.001). The intervention effect persisted, slightly attenuated, in the year following the intervention (2011), further increasing intervention value for money.
Conclusions 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-and-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.
Original languageEnglish
Pages (from-to)2100-2109
Number of pages10
JournalInternational Journal of Epidemiology
Volume45
Issue number6
Early online date03 Dec 2016
DOIs
Publication statusPublished - 2016

Keywords

  • Home-based HIV testing
  • Gift voucher intervention
  • Difference-in-differences
  • Rural South Africa

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