Cash Transfers to Pregnant Women With HIV

NCT07226492 | Recruiting

• 2 other identifiers: 8571934K23MH131464-04
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 3

Brief Summary

The goal of this study is to evaluate the effectiveness and implementation of an unconditional cash transfer intervention to improve mental bandwidth, ART adherence, and postpartum retention among pregnant women with HIV in Botswana. The main questions it seeks to answer are:

1. 1.Do unconditional monthly cash transfers improve mental bandwidth relative to usual care among pregnant women with HIV?
2. 2.Do unconditional monthly cash transfers improve ART adherence (PDC) during pregnancy and the postpartum period?
3. 3.Is delivery of UCTs via mobile money feasible and acceptable in public ANC clinics in Botswana?
4. 4.What barriers and facilitators affect implementation, and how should the model be adapted for a larger trial or a policy pilot (e.g., a pregnancy support grant)?

Conditions

HIV; Pregnancy; HIV Antiretroviral Therapy (ART) Adherence; Post-partum

Keywords

Cash-transfer

Outcome Measures

Primary Outcomes (5)

• Antiretroviral Therapy (ART) adherence

  Proportion of doses covered: Sum of days covered by dispensed medication in the observation period) / (Total number of days in the observation period). This is using pharmacy refill data.

  From baseline visit through 6 months post-partum

• Mental bandwidth: Psychomotor Vigilance Task

  Results from Psychomotor Vigilance Task (response time, number of minor lapses and false starts)

  At baseline visit, gestational age ≥ 30 weeks (visit 2), 3-6 months post-partum (visit 3)

• Mental bandwidth: Raven's Progressive Matrices

  Raven's Progressive Matrices short form (number of correct answers)

  Baseline visit, gestational age ≥30 weeks (visit 2), 3-6 months post-partum (visit 3)

• Feasibility of intervention

  Feasibility of Intervention Measure, 4-item scale (1-4), higher score indicates greater feasibility; Qualitative interview

  At gestational age ≥ 30 weeks (visit 2), 3-6 months post-partum (visit 3); qualitative interviews are 3-8 months post-partum

• Acceptability of intervention

  Acceptability of Intervention Measure, 4-item scale (1-4), higher score indicates greater acceptability; Qualitative interview

  At gestational age ≥ 30 weeks (visit 2), 3-6 months post-partum (visit 3); qualitative interviews are 3-8 months post-partum

Secondary Outcomes (12)

• Food security

  At baseline visit, gestational age ≥ 30 weeks (visit 2), 3-6 months post-partum (visit 3)

• Time Preferences (Future Orientation)

  At baseline visit, gestational age ≥ 30 weeks (visit 2), 3-6 months post-partum (visit 3)

• Time Horizon

  At baseline visit, gestational age ≥ 30 weeks (visit 2), 3-6 months post-partum (visit 3)

• Hope

  At baseline visit, gestational age ≥ 30 weeks (visit 2), 3-6 months post-partum (visit 3)

• Stress

  At baseline visit, gestational age ≥ 30 weeks (visit 2), 3-6 months post-partum (visit 3)

Study Arms (2)

Cash-Transfer Intervention

EXPERIMENTAL

Receives usual care and Unconditional Cash Transfers (UCTs) of 1,000 BWP/month

Other: Unconditional Cash Transfer (UCT)

Usual care

NO INTERVENTION

Receives usual care and standard social support

Interventions

Unconditional Cash Transfer (UCT) OTHER

Unconditional Cash Transfer (UCT) of 1,000 BWP/month

Cash-Transfer Intervention

Eligibility Criteria

• Age: 18 Years+
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age 18 years or greater
• Botswana citizen
• Seeking/receiving antenatal care at antenatal clinics managed by the District Health Management Teams in Gaborone and Mogoditsane-Thamaga District
• Confirmed pregnancy by standard laboratory methods (generally urine testing)
• \<20 weeks gestational age (by ultrasound dating)
• HIV seropositive
• Economically vulnerable (self-reported annual income below the Botswana poverty line of 14,000 BWP per year, equivalent to the international poverty line of $2.15 in 2017 purchasing power parity)

You may not qualify if:

• Unable to provide consent
• Cognitive impairment, per discretion of study staff
• Cannot be in the same household as another enrolled study participant

Sponsors & Collaborators

• University of Pennsylvania: lead
• University of Botswana: collaborator
• National Institute of Mental Health (NIMH): collaborator

Study Sites (3)

Lesirane Clinc

Gaborone, Botswana

NOT YET RECRUITING

Mafitlhakgosi Clinic

Gaborone, Botswana

NOT YET RECRUITING

Old Naledi Clinic

Gaborone, Botswana

RECRUITING

Related Publications (6)

• Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983 Dec;24(4):385-96. No abstract available.

  PMID: 6668417 BACKGROUND

• Snyder CR, Sympson SC, Ybasco FC, Borders TF, Babyak MA, Higgins RL. Development and validation of the State Hope Scale. J Pers Soc Psychol. 1996 Feb;70(2):321-35. doi: 10.1037//0022-3514.70.2.321.

  PMID: 8636885 BACKGROUND

• Laajaj R. Endogenous time horizon and behavioral poverty trap: Theory and evidence from Mozambique. Journal of Development Economics. 2017;127:187-208.

  BACKGROUND

• Falk A, Becker A, Dohmen T, Huffman D, Sunde U. The Preference Survey Module: A Validated Instrument for Measuring Risk, Time, and Social Preferences. Human Capital and Economic Opportunity Working Group;2016.

  BACKGROUND

• Weiner BJ, Lewis CC, Stanick C, Powell BJ, Dorsey CN, Clary AS, Boynton MH, Halko H. Psychometric assessment of three newly developed implementation outcome measures. Implement Sci. 2017 Aug 29;12(1):108. doi: 10.1186/s13012-017-0635-3.

  PMID: 28851459 BACKGROUND

• Deitchler M, Ballard T, Swindale A, Coates J. Introducing a simple measure of household hunger for cross-cultural use. Washington, DC: Food and Nutrition Technical Assistance II project, AED. 2011.

  BACKGROUND

Central Study Contacts

Aaron G Richterman, MD, MPH

CONTACT

267-441-7915; Aaron.Richterman@Pennmedicine.upenn.edu

Charlotte N Babbin, BA

CONTACT

2039151038; charlotte.babbin@pennmedicine.upenn.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 3, 2025
• First Posted: November 10, 2025
• Study Start: March 9, 2026
• Primary Completion (Estimated): January 4, 2028
• Study Completion (Estimated): January 4, 2028
• Last Updated: March 13, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

BO (3)