Studies have found that conditional cash transfer programs, in which governments pay citizens if they consistently practice societally beneficial behaviors, have improved pediatric health care and education in Mexico, increased HIV testing in Malawi, and reduced sexually transmitted infections in Tanzania. Public health researchers therefore investigated whether the idea could be applied to HIV risk behaviors among gay men and male sex workers in Mexico City. A new study reports not only that some members of those populations would change behavior for conditional cash payments, but the exact prices they would accept.
“We’re trying to prevent HIV from spreading and we are trying to save money,” said public health economist Omar Galárraga, assistant professor of health services policy and practice and lead author of the study published in the European Journal of Health Economics. “We want to make sure that every dollar spent has the greatest impact.”
In Mexico, like many other Western nations, the HIV epidemic is especially concentrated within certain populations. Among the capital city’s young gay men and male sex workers, the estimated prevalence of HIV infection is about 20 and 30 percent respectively. The Mexican government’s health care policy, meanwhile, offers universal access to HIV therapy, which costs $5,000 to $7,000 a year.
Through detailed questionnaires administered to 1,745 gay men 18-25 years of age, Galárraga and his colleagues in Mexico’s Institute for Public Health (INSP) found that at a rate of $288 a year, more than three-quarters of the men would attend monthly prevention talks, engage in testing for sexually transmitted infections, and pledge to stay free of STI’s with testing to verify that. To obtain a similar level of participation among the 5.1 percent of the sample who were male sex workers, the price was much lower: $156 a year.