Pay young women in Malawi to prevent HIV infection?

The Guardian reports: “Cash payments help cut HIV infection rate in young women, study finds: Research in Malawi finds girls who receive regular payments are able to resist attentions of older men and avoid infection.” The headline pretty much says it all … or does it?

The Guardian report is based on a study that appeared in The Lancet: “Effect of a cash transfer programme for schooling on prevalence of HIV and herpes simplex type 2 in Malawi: a cluster randomised trial.” It’s accompanied with an editorial, “Paying to prevent HIV infection in young women?”

The study’s interpretation of the findings is the telltale heart of the matter:

Cash transfer programmes can reduce HIV and HSV-2 infections in adolescent schoolgirls in low-income settings. Structural interventions that do not directly target sexual behaviour change can be important components of HIV prevention strategies.

Pay to prevent HIV infection in young women? Yes. But the larger lesson is that women’s health and wellbeing is always part of the whole life of each woman and girl as well as of women and girls, more generally. HIV transmission is not ‘simply’ a consequence of sexual behavior, whatever that is. It emerges from the whole life. Paying to prevent HIV infection in young women is an investment in women’s education and in women’s autonomy, and that is a real investment in a better future and an improved present.

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