Can Paying African Kids to Stay HIV-Free Help Stem AIDS?

By Veronique Greenwood | June 7, 2011 1:51 pm

girls

What’s the News: Researchers have embarked upon an experiment that, if not for the tragic circumstances of the African AIDS epidemic, might be familiar to many parents: paying kids to follow the rules. South African schoolchildren 13 years and older in the study could earn up to $400 if they manage to stay HIV-free for 24 months. In South Africa, which has the most HIV/AIDS-infected people of any country in the world, more than 17 percent of the population has HIV, with girls at especially high risk.

How the Heck:

  • The experiment began last September, when the Centre for the AIDS Programme of Research in South Africa (CAPRISA) set up shop in 14 schools in KwaZulu-Natal, with students at seven schools offered payments and the others serving as controls.
  • The study, which will run until the end of 2012, is unusual in that it engages both females and males. Since women have the highest rates of HIV—of HIV-infected people aged 15–24, 76% are women—many attempts to bring down infection have focused on them, but since they rarely hold the power in sexual relationships, changes in men’s behaviors are needed as well.

What’s the Context:

  • A 2010 study of girls in Malawi designed to see if payments would get them to stay in school also found that girls who didn’t drop out had 60% lower rates of HIV, which was the seed for the CAPRISA study. That study didn’t check to see if initial rates of HIV were the same between girls who were offered payment and those who weren’t, necessitating follow-ups like this one.
  • South Africa’s situation is particularly desperate because of its government’s long history of AIDS denialism, primarily under former president Thabo Mbeki, who doubted the connection between HIV and AIDS and forbade the use of antiretroviral drugs in public hospitals, causing hundreds of thousands of deaths and contributing to the current high incidence of HIV (instead, his health minister advocated eating potatoes and garlic to stop AIDS). Mbeki resigned in 2008.

Not So Fast: Critics of the study’s approach point out that even if payments succeed in keeping children from getting HIV, once the money stops, infection rates might go right back up. “Girls in South Africa have sex for the same reason that girls elsewhere have sex: because they fancy the bloke, because sex is fun, because it makes them feel grown-up, or loved, or desirable, or cool. Will cash make a girl have safer sex, use condoms more frequently? If so, there’s every chance that the condoms will disappear once the bribes do,” one AIDS epidemiologist told Nature News.

The Future Holds: Advocates counter that the habits the children learn over the course of the study might stick—and at any rate, given the situation, any measure that helps even for a while is preferable to none. When the study’s results are published probably in several years, they will help inform the direction of future AIDS prevention.

(via Nature News)

Image credit: Star for Life via Wikimedia Commons

CATEGORIZED UNDER: Health & Medicine
  • Liberalism’s A Sickness

    Great idea, one only a braindead, secular leftist (but I repeat myself) could come up with. Maybe they could also lower the astonishingly high incidence of child-rape in Africa by paying rapists not to rape babies and toddlers. Better yet, with enough public money they could eliminate murder by paying people not to murder. Eureka!

  • http://onefuriousllama.com One Furious Llama

    Presumably you have a much better idea on what to do, hey Mr. Outraged at #1?

    It’s a study to see how people behave under certain conditions and to see what can be learnt.

    It’s a study fool. Without studying there isn’t any learning and if every scientist in history had this reaction to possibly ridiculous subjects we’d be nowhere today.

  • Liberalism’s A Sickness

    Um, Llama, please tell me what there is to “study”? When societies and cultures implode, paying barbarians within that culture to refrain from being what they are and not doing what barbarians naturally do is not going to stave off the inevitable. They are what they are, period. Pretty much the same thing is happening to this country as well, but in different behavioral arenas. It’s all coming down around our heads, and if anything should have been “studied,” my good man, it should have been the Bible. Fear of the Lord comes before true wisdom.

  • Wesley

    And there’s the punch line to his line of ‘reasoning’. Religion and logic just don’t mix.

  • Katharine

    I see the brainless religious rightist isn’t trotting out anything to support his claims. Oh, and he brings up his silly imaginary friend too! All storm and fury and no substance from him.

    They’ve done these kinds of experiments before. They’ve worked.

    The phenomena you’re referring to – AIDS and rape and such – are considerably more complex than you suspect, and while I hate idiots who have the opportunity to protect themselves during sex and don’t take it and/or rape people as much as the next person (and idiots in general, one of them being you), you’re blatantly ignoring actual published research on the subject.

  • LVGreen

    >>”…paying barbarians within that culture to refrain from being what they are and not doing what barbarians naturally do is not going to stave off the inevitable.”<<

    It worked for Rome. Until they could no longer afford to pay the Visigoths of course. But for close to a century it worked. But I guess that is too literal a contradiction to your contention of "barbarians."

    And lefties hate markets and profits. So this would be conceived by "secularists" who is knowledgeable in the workings of markets and behavioral economics. And bully for them.

  • Brian Too

    Allow me to be skeptical of this program.

    A highly likely outcome is that many of the targetted youngsters will attempt to take the money and still be sexually active. Why not have it all?

    It’s illogical of course, but put yourself in the shoes of a teenager. Free money is on offer. You say yes, that’s a no-brainer! Now when the boyfriend/girlfriend thing is getting hot and heavy, caution and the future goes out the window. Maybe they even get away with it, at least for a while.

    Overall, I expect success rates for such a program to be on the low side. It might be worth it even then though. You are working on the margins, preventing a chronic disease (and often fatal in impoverished areas). As long as the payment is not made until after the agreed timeframe has lapsed.

    Of course the teens can still win by engaging in sexual activity with condoms.

  • http://obfuscatism.blogspot.com Malcolm

    Ummm… Brian. The point isn’t “Don’t have sex”, it’s “Don’t get HIV”.

    You say: “the teens can still win by engaging in sexual activity with condoms”

    EVERYBODY wins if the teens have sex with condoms! =D

  • Liberalism’s A Sickness

    Yeppers, that’s what we need to change their behavior – a study! Why not take this a little further and eliminate 0ne million yearly abortions in the United States by “studying” why so many girls carelessly get pregnant and then murder their babies? Ooops, I forgot. All of them were either raped or didn’t know about condoms. Yup, only a leftist graduate student could believe such drivel.

  • Liberalism’s A Sickness

    Yeppers, that’s what we need to change their behavior – a study! Why not take this a little further and eliminate 0ne million yearly abortions in the United States by “studying” why so many girls carelessly get pregnant and then murder their babies? Ooops, I forgot. All of them were either raped or didn’t know about condoms. Yup, only a leftist graduate student could believe such drivel.

    As for Brians comment, “Of course the teens can still win by engaging in sexual activity with condoms,” this is rather like saying you can “win” at Russian Roulette by using one bullet in the chamber rather than two. The failure rate for condoms is almost 20%, and with anal sex it’s estimated to be as high as 50%. Not very good odds when the results are either dead, aborted infants or homosexuals typically dying of AIDS in their 30s.

  • fintin

    Well, Sickness, instead of riddling this conversation with inept sarcasm, since you undoubtedly know what solution would solve the aids/hiv problem, then I implore you, please tell us your genius plan, as we leftist graduate students are just DYING to know.

  • kheun

    Money can’t buy everything. IMHO, this experiment seem to be trial-and-error without identify the real cause. Since money seem to halt the problem, I am guessing that it may indicate that the problem is due to poverty. If the income of each family can be increased, it may resolve the issue. Anyway, more effective studies are still needed to identify the real root cause before the problem can be effectively solved.

  • Liberalism’s A Sickness

    Um, lots of things are due to poverty. Does it therefore follow that we should legalize every criminal act on the books because of that? Besides which, if as you little socialist street urchins seem to suggest, since every social pathology imaginable is due solely to poverty, then how do you explain away the fact that some of the most evil people on the planet are also amongst the most powerful and wealthy people as well? We’re waiting.

  • Curious

    What is your measure of evil? I think we need to hold a study to determine whether evil and wealth is merely a correlation or whether it may actually be a causation. Once we establish a set of indicators for our measure of evil, we can then go ahead and get a sample group of poor people, measure their level of evil, make them wealthy, then measure their level of evil again. Of course, while comparing with a control group that stays poor. Wait…..but what if evil is the cause of wealth?!!

  • Tron

    If it’s such an evil thing to be wealthy, then why are poor, noble, virtuous poor people always trying to steal our money?

  • Liberalism Is A Sickness

    Fintin, it doesn’t take a genius to understand that when certain behaviors are putting you at risk, you simply regulate or stop those behaviors altogether. I find it very curious that the very same people who tell smokers to stop their risky behavior are the very same ones handing out condoms to 12 year olds. If this double standard were not in existence, by logical extension we would be handing out filtered cigarettes to teen smokers. See anything wrong with this picture? Well, most of us conservatives certainly do.

    Similarly, why do we hammer smokers day in and day out for endangering their health while making not a peep about the reckless sexual behavior of so many homosexual men, behaviors which kill them in far greater numbers and at far earlier ages than cigarettes ever could – even smoking a couple packs a day.

    Hell, society has deliberately shamed smokers into hiding and made of them second class citizens. However, this very same culture absolutely refuses to make a peep about what homosexual men are doing for fear of offending their powerful Pink Lobby in DC. No, instead we are spending billions of taxpayer dollars trying to find a cure for AIDS. Gee, following this same logic we should also be spending billions trying to find a “cure” for lung cancer associated with smoking. There is not a whit of difference to the extent that AIDS in this country is overwhelmingly a function of male homosexuality.

    So, my answer to you is to make reckless sexual behavior taboo, as it once was. Do with these people what we did to smokers…shame them and ridicule them mercilessly.

  • fintin

    Ok, but remember, these are teenagers we’re talking about- titillated young people in the prime of their life, who don’t know what the real world is like. They are subjected to peer pressure, and are constantly witnessing new kinds of things that are “hot” on tv, such as sex. If these were adults we were talking about, then that would be different, but these are teenagers, who know better than to spread disease, but don’t want to do anything about it. I’m not saying it’s their fault- it is. But for teenagers, the urge to have sex is bigger than the resistance to it. Studies are made to find out what can stop a teen from having sex. Ridiculing them is not going to get us anywhere, as sex and smoking are two very different things. Smoking is a poisonous habit, no matter what, but sex is more 50/50. Sex is something that everyone feels and craves, and isn’t always dangerous, while smoking is and always will be dangerous. Besides, even if we do stop all these teens from spreading AIDS, there would still be tons of AIDS out there. Finding the cure to AIDS is necessary, not an excuse to lead us from disciplining teenagers. I agree that discipline is needed, but in a simpler way, instead of “ridiculing” them.

  • Brian Too

    @ Liberalism Is A Sickness,

    Just because we cannot (or have difficulty) making progress on one issue does not mean we cannot make progress on another. Nor is society obligated, in any way shape or form, to prioritize problems. Nor to schedule them, either. Politicians are responsible for a great deal of this and, in this case, I think that’s a good thing overall.

    Your example of smoking is telling. There was a time when smoking was nearly immune to any kind of pressure no matter what the facts said. It took a long time to change cultural norms and they still haven’t changed in most of the developing world.

    Also, I find your need to cast this issue in political left versus right objectionable. Your very posting name hints at a monotonic need to ride that hobby horse at every turn. I saw a similar behaviour a few years ago. It was in the Granma newspaper in Cuba.

  • LOLWUT?

    Sickness, you are truly an idiot. I agree that this study if foolish. However, you caused me to bust out with laughter with your “statistics” in this quote …

    “The failure rate for condoms is almost 20%, and with anal sex it’s estimated to be as high as 50%. Not very good odds when the results are either dead, aborted infants or homosexuals typically dying of AIDS in their 30s.”

  • reidh

    wouldn’t it be cheaper in the long run to pay them to contract and spread AIDs ?

  • Ashley Cakes

    Hey, “Liberalism is a Sickness:” I don’t know if you’ve noticed, but this is discovermagazine.com, a website for a SCIENTIFIC magazine and people who are interested in SCIENCE. It’s not a place for homophobic, moronic, anti-abortionist, abstinence-only-advocating idiots like you who seem to only study the notoriously poorly-written book of contradictions known as the Bible. Get a clue. Telling people to ignore their evolutionary instinct to have sex as the “cure” for AIDS and a prevention for abortions is not only unscientific, it’s idiotic and proven to be ineffectual. Telling people that gay men are the cause of AIDS is just so incredibly stupid that I almost can’t believe I’ve come across such an ignorant comment on a scientific article. Wow. Sometimes you religious, ultra-conservative, right-winged types still amaze me.

  • fintin

    Then he decides to come up with some completely ridiculous solution to AIDS by shaming and ridiculing the teens. When I read that, I wondered if this was a 10 year old I was talking to.

  • http://www.artofjquery.com Art of jQuery

    HIV must be controlled, they must be educated and a new structure should be implemented.

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