Cash transfer interventions for sexual health: meanings and experiences of adolescent males and females in inner-city Johannesburg

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dc.contributor.authorKhoza, Nomhle
dc.contributor.authorStadler, Jonathan
dc.contributor.authorMacPhail, Catherine
dc.contributor.authorChikandiwa, Admire
dc.contributor.authorBrahmbhatt, Heena
dc.contributor.authorDelany-Moretlwe, Sinead
dc.date.accessioned2024-08-22T12:34:46Z
dc.date.available2024-08-22T12:34:46Z
dc.date.issued2018
dc.description.abstractBackground: In sub-Saharan Africa, there is growing interest in the use of cash transfer (CT) programs for HIV treatment and prevention. However, there is limited evidence of the consequences related to CT provision to adolescents in low-resourced urban settings. We explored the experiences of adolescents receiving CTs to assess the acceptability and unintended consequences of CT strategies in urban Johannesburg, South Africa. Methods: We collected qualitative data during a pilot randomized controlled trial of three CT strategies (monthly payments unconditional vs. conditional on school attendance vs. a once-off payment conditional on a clinic visit) involving 120 adolescents aged 16–18 years old in the inner city of Johannesburg. Interviews were conducted in isiZulu, Sesotho or English with a sub-sample of 49 participants who adhered to study conditions, 6 months after receiving CT (280 ZAR/ 20 USD) and up to 12 months after the program had ended. Interviews were transcribed and translated by three fieldworkers. Codes were generated using an inductive approach; transcripts were initially coded based on emerging issues and subsequently coded deductively using Atlas.ti 7.4. Results: CTs promoted a sense of independence and an adult social identity amongst recipients. CTs were used to purchase personal and household items; however, there were gender differences in spending and saving behaviours. Male participants’ spending reflected their preoccupation with maintaining a public social status through which they asserted an image of the responsible adult. In contrast, female participants’ expenditure reflected assumption of domestic responsibilities and independence from older men, with the latter highlighting CTs’ potential to reduce transactional sexual partnerships. Cash benefits were short-lived, as adolescents reverted to previous behavior after the program’s cessation. Conclusion: CT programs offer adolescent males and females in low-income urban settings a sense of agency, which is vital for their transition to adulthood. However, gender differences in the expenditure of CTs and the effects of ending CT programs must be noted, as these may present potential unintended risks.
dc.description.sponsorshipUKaid USAID- GHH-I-00-07-00032-00.
dc.description.submitterPM2024
dc.facultyFaculty of Health Sciences
dc.identifier0000-0003-1312-7783
dc.identifier.citationKhoza, N., Stadler, J., MacPhail, C., Chikandiwa, A., Brahmbhatt, H., & Delany-Moretlwe, S. (2018). Cash transfer interventions for sexual health: meanings and experiences of adolescent males and females in inner-city Johannesburg. BMC public health, 18(1), 120. https://doi.org/10.1186/s12889-018-5027-3
dc.identifier.issn1471-2458 (online)
dc.identifier.other10.1186/s12889-018-5027-3
dc.identifier.urihttps://hdl.handle.net/10539/40271
dc.journal.titleBMC Public Health
dc.language.isoen
dc.publisherBMC
dc.relation.ispartofseriesVol. 18; No. 120
dc.rights© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License.
dc.schoolSchool of Clinical Medicine
dc.subjectCash transfers
dc.subjectAdolescents
dc.subjectGirls
dc.subjectBoys
dc.subjectSouth Africa
dc.subject.otherSDG-17: Partnerships for the goals
dc.titleCash transfer interventions for sexual health: meanings and experiences of adolescent males and females in inner-city Johannesburg
dc.typeArticle
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