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Table 3 Primary and secondary outcomes in this analysis and their measurements, populations for which they were considered, and hypothesised links to cash transfers

From: Spillover HIV prevention effects of a cash transfer trial in East Zimbabwe: evidence from a cluster-randomised trial and general-population survey

Outcome

Measurement

Population

Hypothesised links to CTs

Primary outcomes

Any recent sexual activity

Had sexual intercourse in the past 30 days

M & F (15–29)

M & F (30–54)

(who had sex before)

Females: CTs may lead to economic empowerment and reduce the economic necessity to engage in transactional relationships or sex work, which may be reflected in lower numbers of sexual partners and having recent sexual intercourse. Increased school enrolment (and so attendance) may reduce sexual activity and numbers of partners. Similarly, CTs may reduce economic barriers to accessing condoms and economic dependence on sexual partners, so condom use may be more viable.

Males: Increased sexual activity and number of partners and reduced condom use may be adverse effects of the economic empowerment through CTs, while increased school enrolment (and attendance) may reduce sexual activity.

Multiple sexual partners

> 1 sexual partner in past 12 months

Condom use

Condom use during last sexual intercourse

Sexual debut

Having had sex before

M & F (15–20)a

CTs may lead to delayed sexual debut partially through improved school enrolment and by reducing economic incentives to engage in sexual activity (for females).

Secondary outcomes

Psychological distress

≥7 symptoms of psychological distress (25-item scale)

M & F (15–29)

M & F (30–54)

Poverty and income inequality can lead to psychological distress, which may be alleviated with CTs. See [46] for details.

School enrolment

Currently enrolled in schoolb

M & F (15–20)c

CTs remove economic barriers to school enrolment. School attendance was also a condition in the conditional CT intervention.

Alcohol use

Visited a beer hall in past 30 days or having > 3 drinks when drinking alcohol

M & F (15–29)

M & F (30–54)

Adverse effects of CTs could include non-sexual potentially health-damaging behaviours, including alcohol and drug use and cigarette smoking. Alcohol and drug use could also lead to increase in potentially risky sexual behaviour.

Smoking

Current smoking of cigarettes

Drug use

Taking any type of recreational drug

  1. CTs Cash transfers, M Males, F Females
  2. Numbers after populations refer to age range in years. Data on all measures were taken from the Manicaland Cohort study. See Additional file 2 (section 1) for details on data and measurements.
  3. a Sexual debut was evaluated among those aged 15–20 instead of all young people because most young people will have had their sexual debut by the age of 20
  4. b The original Manicaland Trial measured school attendance, not enrolment, which is not directly comparable to the measure of school enrolment in the Manicaland Cohort
  5. c School enrolment was evaluated among those aged 15–20 instead of all young people because it is not applicable to older people