A Household Food Voucher Increases Consent to Home-Based HIV Testing in Rural KwaZulu-Natal

Mark E. McGovern, Harvard University
David Canning, Harvard University

Despite the importance of HIV testing for controlling the HIV epidemic, testing rates remain low in many countries. Using a difference-in-differences approach, we evaluate the effect of allocating a food gift voucher to households in rural KwaZulu-Natal, South Africa, on consent rates for home-based HIV testing. The voucher increased the probability of household members consenting to test by 29 percentage points (95% CI 23 - 35). We also find an attenuated effect of treatment on consent rates in 2011. We estimate the cost of the program at 7 USD per additional test. The provision of gift vouchers to surveillance participants is likely to be an effective tool for raising consent rates for home-based HIV testing. In addition, by persuading respondents who would ordinarily refuse to test in the absence of the voucher effect, this approach can potentially be used to assess the extent of selection bias in the population.