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OpenTrials
Active, not recruiting

NCT Number: NCT05385484

A Savings Intervention to Reduce Men's Engagement in HIV Risk Behaviors

This randomized control trial will test an economic intervention to reduce Kenyan men's engagement in behaviors that increase the risk of HIV/STIs. Participants randomized to the intervention group will be able to open accounts with a partner bank and will be incentivized to save with lottery-based rewards.

Active, not recruiting

This study is active but is not currently recruiting participants.

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Key information

About this study

This project will evaluate an innovative, theoretically-motivated economic intervention to reduce men's engagement in transactional sex and other risky behaviors. Leveraging innovations in mobile financial services and research on savings behavior in low-income countries, the investigators propose to test an intervention that seeks to motivate high-risk, income-earning men in western Kenya to reduce their spending on risky behaviors and instead save their disposable income in local bank accounts. These bank accounts will include additional incentives to save in the form of lottery-based rewards linked to amounts saved. The intervention will also encourage participants to develop savings goals and strategies, and provide periodic reminders about saving regularly. Through a direct economic mechanism (incentives to shift expenditures from the present to the future) and a psychological mechanism (increasing future orientation), the investigators hypothesize that the intervention will result in increased savings, reduced spending on transactional sex and alcohol, less risky sexual behavior, and reduced risk of HIV and sexually transmitted infections (STIs).

The investigators will conduct a randomized controlled trial among men who are at high risk of HIV and STI infection and determine the effects of a savings intervention on health and economic outcomes. Specific aims of the project are as follows. Aim 1: Determine the impact of the intervention on savings and investment behavior, self-reported sexual behavior, and incidence of HIV/STIs. Aim 2: Quantitatively and qualitatively assess mechanisms of behavior change among participants and a sample of their female partners.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Male
  • Age 18-39 years
  • Resides in study community and plans to remain for the next 2 years
  • Used alcohol or other substances in the past month
  • Engagement in any transactional sex (defined as payment of money, goods, or services in exchange for sex) in the past 3 months
  • Has a steady income source that typically results in earnings every week
  • Owns mobile phone
  • Already has or is willing to open an account with partner banking institution
  • Has national identification card (required for opening bank account)
  • Has Kenya Revenue Authority personal identification number or is willing to create one (required for opening bank account)

Exclusion criteria

  • None

Treatment and study plan

Receives mobile banking account with incentives to save

Behavioral

Participants will receive assistance in opening and using a mobile savings account, will be given education emphasizing saving practices and will be told about lottery-based incentives opportunities.

Basic Health and financial education

Other

Participants in the control group will be given basic information on the importance of saving for the future. In addition, health education curriculum developed by Impact Research & Development Organization (IRDO) will be provided to participants with standard health education on places to seek services for HIV and STI prevention and treatment, including information on alcohol and transactional sex as risk factors for HIV transmission.

Primary outcomes

  1. Incidence of HIV and Other STIs

    Time frame: 24 months

    Composite incidence of at least one of HIV or other STIs (herpes simplex virus type 2 (HSV-2), Neisseria gonorrhoeae (NG), and Chlamydia trachomatis (CT)) over 24 months. The investigators will combine all STIs (including HIV) into a composite variable, with each participant counting once. For participants who are HIV-positive at baseline or HSV-2-positive, the outcome will be defined over all STIs other than HIV.

Secondary outcomes

  1. Expenditures on Alcohol (Self and Others)

    Time frame: 24 months

    Money spent on alcohol during a 6 month period (2022 USD, winsorized at the 95th percentile)

  2. Expenditures on Transactional Sex

    Time frame: 24 month

    Money, goods, and services spent on transactional sex (defined broadly to include financial and non-financial transfers to commercial and non-commercial sexual partners) during a 6 month period (2022 USD, winsorized at the 95th percentile)

  3. Expenditures on Gambling

    Time frame: 24 month

    Money spent on gambling during a 6 month period (2022 USD, winsorized at the 95th percentile)

  4. Number of Sexual Partners

    Time frame: 24 month

    Number of sexual partners participant had in the past 3 months.

  5. Participant Engaged in Transactional Sex in the Last 3 Months

    Time frame: 24 month

    Participant engaged in transactional sex (defined broadly to include renumerating someone via financial and non-financial transfers for sexual activities), in the past 3 months (binary yes=1/no=0). The question from the survey: "In the past 3 months, have you exchanged money, goods, gifts, food (including fish), housing or services for sex?"

  6. Number of Transactional Sex Partners

    Time frame: 24 month

    Total number of transactional sex partners participant had in the past 3 months.

  7. Number of Transactional Sex Encounters

    Time frame: 24 month

    Number of transactional sex encounters participant engaged in during the past 3 months (winsorized at the 95th percentile).

  8. Participant Used Condom at Most Recent Sexual Encounter in the Past 3 Months

    Time frame: 24 month

    Participant used a condom at most recent sexual encounter in the past 3 months (binary: yes=1/no=0). The question from the survey: "In your last sexual encounter in the past 3 months, did you use a condom?"

  9. Alcohol Use (Hazardous Drinking)

    Time frame: 24 month

    As measured by the Alcohol Use Disorders Identification Test-Concise (AUDIT-C) scale. The AUDIT-C is scored on a scale of 0-12, and higher values mean worse outcomes. We measure hazardous drinking, as indicated by an AUDIT-C score >=4.

  10. Expenditures on Food

    Time frame: 24 month

    Money spent on food items during a 6-month period (2022 USD, winsorized at the 95th percentile)

  11. Expenditures on Household Needs

    Time frame: 24 month

    Money spent on household needs (including personal items; clothing and shoes; household items; utilities; and transport) during a 6-month period (2022 USD, winsorized at the 95th percentile)

  12. Savings and Investment

    Time frame: 24 months

    Total savings and investment, defined as the money value of formal and informal savings as well as investments in physical and human capital.

  13. Total Informal Savings

    Time frame: 24 month

    The sum of savings held outside of formal institutions, including savings groups and money saved at home or elsewhere

  14. Total Formal Savings

    Time frame: 24 month

    The sum of savings balances in all formal bank accounts.

  15. Total Household Assets

    Time frame: 24 month

    Value of all assets (2022 USD, winsorized at the 95th percentile).

  16. Expenditure on Human Capital Investment

    Time frame: 24 month

    Money spent on human capital investment (e.g., spending on children's education) during a 6-month period (2022 USD, winsorized at the 95th percentile)

  17. Housing Improved in the Past 6 Months

    Time frame: 24 months

    Housing was improved in the past 6 months, e,g, repaired or constructed home's walls, roof, floor, toilet source, or drinking water source (yes=1/no=0). The question from the survey: "Have you made any additions or improvements to your house in the last 6 months? For example, have you repaired or constructed your home's walls, roof, floor, toilet source, drinking water source?"

  18. Perpetuation Intimate Partner Violence

    Time frame: 24 month

    Perpetuation of physical, psychological, or sexual IPV

  19. Experienced Intimate Partner Violence

    Time frame: 24 month

    Experienced physical, psychological, or sexual IPV

  20. Perceived Financial Security

    Time frame: 24 month

    Financial wellbeing scale is a 10 item scale (Fu, J. (2020). Ability or opportunity to act: what shapes financial well-being?. World Development, 128, 104843). The scale is called the financial wellbeing scale. The total score ranges from 1 to 8 with lower values indicating poorer financial wellbeing.

  21. Food Security

    Time frame: 24 month

    3 item scale from Household Food Insecurity Access Scale. 0 to 9 with higher scores indicating higher food insecurity

  22. Stress

    Time frame: 24 month

    Cohen's Perceived Stress Scale, PSS. 0 to 40 with higher scores indicating higher perceived stress

  23. Stress, Helplessness

    Time frame: 24 month

    Perceived helplessness score (subscale of PSS). 0 to 24 with higher scores indicating higher helplessness

  24. Stress, Self-efficacy

    Time frame: 24 month

    Perceived self-efficacy score (subscale of PSS). 0 to 16 with higher scores indicating higher self-efficacy

  25. Most Future Oriented

    Time frame: 24 month

    Assessed by a commonly-used scale that asks participants to make hypothetical choices between money received at two different times (e.g., 1,000 Shillings in 1 month vs. 1,100 Shillings in 2 months). Based on their responses participants are grouped into one of four ordinal groups that range from least to most future oriented. This was then binarized into the most future oriented group (category 4) versus less future oriented (categories 1 through 3).

  26. Future Orientation, Well Being

    Time frame: 24 month

    Cantril scale which measures participant's well-being. 0 to 10 with higher scores indicating higher well being

  27. Future Orientation, Longevity

    Time frame: 24 month

    11-point scale that assesses participant's expectations about their longevity. 0 to 10 with higher scores indicating higher expectations about longevity

Sponsors and collaborators

Lead sponsor

University of Pennsylvania

Other

Collaborators

  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
  • Impact Research & Development Organization
  • RTI International
  • University of California, San Francisco
  • University of Washington

Registry information

Important dates

Study start
2022
Primary completion
2025
Study completion
2027
First posted
May 23, 2022
Registry last updated
Sep 10, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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