Effect of a Lottery Intervention on Gender-Based Violence among Female Sex Workers in Dar es Salaam, Tanzania
Financial incentives are a promising approach for HIV prevention. Some studies have shown that financial incentive interventions aimed to promote positive health and social behaviors have mixed or harmful effects on gender-based violence, and little is known about their effects among higher risk groups such as female sex workers. To address this gap, this study investigated the relationship between a lottery-based incentive and gender-based violence among female sex workers in Dar es Salaam, Tanzania. Data were analyzed from the RESPECT II trial, which enrolled 2,206 female sex workers in Dar es Salaam, Tanzania, to evaluate the effect of a lottery-based incentive on HIV and sexually transmitted infections. Participants were randomized in a one-to-one ratio to: (1) the basic test group (control), which provided baseline testing and counseling for HIV and sexually transmitted infections and bi-weekly text messages on safe sex practices; or (2) the lottery group, which included the basic test group intervention plus entry into a weekly random lottery for an award of 100,000 Tanzanian shillings conditional on negative tests for sexually transmitted infections (syphilis and trichomonas vaginalis). An intent-to-treat analysis was conducted to estimate differences in physical and sexual gender-based violence (overall), and intimate partner violence and non-partner violence between treatment arms at endline, with estimates expressed as unadjusted prevalence differences with 95 percent confidence intervals. Adjusted estimates controlled for baseline reports of violence. Multiple imputation and inverse-probability of treatment weighting were used to account for missing data. Causal, population-level impacts were estimated using g-computation. Gender-based violence, intimate partner violence, and non-partner violence declined in both treatment arms over the study period among the sample of 1,117 female sex workers retained at endline. The lottery group had a lower prevalence of gender-based violence overall, intimate partner violence, and non-partner violence compared to control at endline; however, the differences were not statistically significant. The results indicate that the lottery intervention had no effect on violence outcomes among endline participants in the RESPECT II trial. These results suggest that this economic approach does not pose additional risks of violence in the context of sex work; however, they must be interpreted with caution due to high attrition in the study sample. Additional research is warranted to examine how this incentive mechanism impacts violence for female sex workers.
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Format: | Working Paper biblioteca |
Language: | English English |
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World Bank
2023-10-02
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Subjects: | FEMALE SEX WORKERS AND VIOLENCE, GENDER BASED VIOLENCE, LOTTERY REWARD FOR HEALTH PROMOTION, SEXUALLY TRANSMITTED INFECTION (STI) PREVENTION, RESPECT II, HIV PREVENTION AND VIOLENCE, |
Online Access: | http://documents.worldbank.org/curated/en/099518309262312337/IDU012f77a680a5700400409d1a004cc2565e765 https://openknowledge.worldbank.org/handle/10986/40417 |
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dig-okr-10986404172024-03-11T19:22:20Z Effect of a Lottery Intervention on Gender-Based Violence among Female Sex Workers in Dar es Salaam, Tanzania Results from a Randomized Trial Hémono, Rebecca Balampama, Marianna De Walque, Damien Mccoy, Sandra I. Dow, William H. FEMALE SEX WORKERS AND VIOLENCE GENDER BASED VIOLENCE LOTTERY REWARD FOR HEALTH PROMOTION SEXUALLY TRANSMITTED INFECTION (STI) PREVENTION RESPECT II HIV PREVENTION AND VIOLENCE Financial incentives are a promising approach for HIV prevention. Some studies have shown that financial incentive interventions aimed to promote positive health and social behaviors have mixed or harmful effects on gender-based violence, and little is known about their effects among higher risk groups such as female sex workers. To address this gap, this study investigated the relationship between a lottery-based incentive and gender-based violence among female sex workers in Dar es Salaam, Tanzania. Data were analyzed from the RESPECT II trial, which enrolled 2,206 female sex workers in Dar es Salaam, Tanzania, to evaluate the effect of a lottery-based incentive on HIV and sexually transmitted infections. Participants were randomized in a one-to-one ratio to: (1) the basic test group (control), which provided baseline testing and counseling for HIV and sexually transmitted infections and bi-weekly text messages on safe sex practices; or (2) the lottery group, which included the basic test group intervention plus entry into a weekly random lottery for an award of 100,000 Tanzanian shillings conditional on negative tests for sexually transmitted infections (syphilis and trichomonas vaginalis). An intent-to-treat analysis was conducted to estimate differences in physical and sexual gender-based violence (overall), and intimate partner violence and non-partner violence between treatment arms at endline, with estimates expressed as unadjusted prevalence differences with 95 percent confidence intervals. Adjusted estimates controlled for baseline reports of violence. Multiple imputation and inverse-probability of treatment weighting were used to account for missing data. Causal, population-level impacts were estimated using g-computation. Gender-based violence, intimate partner violence, and non-partner violence declined in both treatment arms over the study period among the sample of 1,117 female sex workers retained at endline. The lottery group had a lower prevalence of gender-based violence overall, intimate partner violence, and non-partner violence compared to control at endline; however, the differences were not statistically significant. The results indicate that the lottery intervention had no effect on violence outcomes among endline participants in the RESPECT II trial. These results suggest that this economic approach does not pose additional risks of violence in the context of sex work; however, they must be interpreted with caution due to high attrition in the study sample. Additional research is warranted to examine how this incentive mechanism impacts violence for female sex workers. 2023-10-02T17:04:43Z 2023-10-02T17:04:43Z 2023-10-02 Working Paper http://documents.worldbank.org/curated/en/099518309262312337/IDU012f77a680a5700400409d1a004cc2565e765 https://openknowledge.worldbank.org/handle/10986/40417 English en Policy Research Working Papers; 10573 CC BY 3.0 IGO https://creativecommons.org/licenses/by/3.0/igo/ World Bank application/pdf text/plain World Bank |
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FEMALE SEX WORKERS AND VIOLENCE GENDER BASED VIOLENCE LOTTERY REWARD FOR HEALTH PROMOTION SEXUALLY TRANSMITTED INFECTION (STI) PREVENTION RESPECT II HIV PREVENTION AND VIOLENCE FEMALE SEX WORKERS AND VIOLENCE GENDER BASED VIOLENCE LOTTERY REWARD FOR HEALTH PROMOTION SEXUALLY TRANSMITTED INFECTION (STI) PREVENTION RESPECT II HIV PREVENTION AND VIOLENCE |
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FEMALE SEX WORKERS AND VIOLENCE GENDER BASED VIOLENCE LOTTERY REWARD FOR HEALTH PROMOTION SEXUALLY TRANSMITTED INFECTION (STI) PREVENTION RESPECT II HIV PREVENTION AND VIOLENCE FEMALE SEX WORKERS AND VIOLENCE GENDER BASED VIOLENCE LOTTERY REWARD FOR HEALTH PROMOTION SEXUALLY TRANSMITTED INFECTION (STI) PREVENTION RESPECT II HIV PREVENTION AND VIOLENCE Hémono, Rebecca Balampama, Marianna De Walque, Damien Mccoy, Sandra I. Dow, William H. Effect of a Lottery Intervention on Gender-Based Violence among Female Sex Workers in Dar es Salaam, Tanzania |
description |
Financial incentives are a promising
approach for HIV prevention. Some studies have shown that
financial incentive interventions aimed to promote positive
health and social behaviors have mixed or harmful effects on
gender-based violence, and little is known about their
effects among higher risk groups such as female sex workers.
To address this gap, this study investigated the
relationship between a lottery-based incentive and
gender-based violence among female sex workers in Dar es
Salaam, Tanzania. Data were analyzed from the RESPECT II
trial, which enrolled 2,206 female sex workers in Dar es
Salaam, Tanzania, to evaluate the effect of a lottery-based
incentive on HIV and sexually transmitted infections.
Participants were randomized in a one-to-one ratio to: (1)
the basic test group (control), which provided baseline
testing and counseling for HIV and sexually transmitted
infections and bi-weekly text messages on safe sex
practices; or (2) the lottery group, which included the
basic test group intervention plus entry into a weekly
random lottery for an award of 100,000 Tanzanian shillings
conditional on negative tests for sexually transmitted
infections (syphilis and trichomonas vaginalis). An
intent-to-treat analysis was conducted to estimate
differences in physical and sexual gender-based violence
(overall), and intimate partner violence and non-partner
violence between treatment arms at endline, with estimates
expressed as unadjusted prevalence differences with 95
percent confidence intervals. Adjusted estimates controlled
for baseline reports of violence. Multiple imputation and
inverse-probability of treatment weighting were used to
account for missing data. Causal, population-level impacts
were estimated using g-computation. Gender-based violence,
intimate partner violence, and non-partner violence declined
in both treatment arms over the study period among the
sample of 1,117 female sex workers retained at endline. The
lottery group had a lower prevalence of gender-based
violence overall, intimate partner violence, and non-partner
violence compared to control at endline; however, the
differences were not statistically significant. The results
indicate that the lottery intervention had no effect on
violence outcomes among endline participants in the RESPECT
II trial. These results suggest that this economic approach
does not pose additional risks of violence in the context of
sex work; however, they must be interpreted with caution due
to high attrition in the study sample. Additional research
is warranted to examine how this incentive mechanism impacts
violence for female sex workers. |
format |
Working Paper |
topic_facet |
FEMALE SEX WORKERS AND VIOLENCE GENDER BASED VIOLENCE LOTTERY REWARD FOR HEALTH PROMOTION SEXUALLY TRANSMITTED INFECTION (STI) PREVENTION RESPECT II HIV PREVENTION AND VIOLENCE |
author |
Hémono, Rebecca Balampama, Marianna De Walque, Damien Mccoy, Sandra I. Dow, William H. |
author_facet |
Hémono, Rebecca Balampama, Marianna De Walque, Damien Mccoy, Sandra I. Dow, William H. |
author_sort |
Hémono, Rebecca |
title |
Effect of a Lottery Intervention on Gender-Based Violence among Female Sex Workers in Dar es Salaam, Tanzania |
title_short |
Effect of a Lottery Intervention on Gender-Based Violence among Female Sex Workers in Dar es Salaam, Tanzania |
title_full |
Effect of a Lottery Intervention on Gender-Based Violence among Female Sex Workers in Dar es Salaam, Tanzania |
title_fullStr |
Effect of a Lottery Intervention on Gender-Based Violence among Female Sex Workers in Dar es Salaam, Tanzania |
title_full_unstemmed |
Effect of a Lottery Intervention on Gender-Based Violence among Female Sex Workers in Dar es Salaam, Tanzania |
title_sort |
effect of a lottery intervention on gender-based violence among female sex workers in dar es salaam, tanzania |
publisher |
World Bank |
publishDate |
2023-10-02 |
url |
http://documents.worldbank.org/curated/en/099518309262312337/IDU012f77a680a5700400409d1a004cc2565e765 https://openknowledge.worldbank.org/handle/10986/40417 |
work_keys_str_mv |
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_version_ |
1794797017726189568 |