Conceptualization of Empowerment and Pathways Through Which Cash Transfers Work to Empower Young Women to Reduce HIV Risk: A Qualitative Study in Tanzania

AIDS Behav. 2020 Nov;24(11):3024-3032. doi: 10.1007/s10461-020-02850-0.


Although cash transfers (CT) are hypothesized to reduce AGYW's HIV risk, little is known about the mechanisms through which CT empower AGYW. We explored the impact of a CT intervention on AGYW's sexual decision-making in order to describe the pathways through which the cash may influence risk behavior. The study employed qualitative methods involving: 20 longitudinal in-depth interviews (IDIs), 40 cross-sectional IDIs, 20 narrative IDIs, and two focus group discussions with AGYW ages 15-23 participating in a CT intervention. AGYW's conceptualized empowerment as: "independence", "hope and aspiration". Potential pathways through which CT empowered AGYW were: economic, hope and aspiration for a better future, and access to knowledge. As a result of this empowerment, AGYW reported reductions in transactional sex, experiences of intimate partner violence, and risky-sexual behaviour. A sense of responsibility developed through economic empowerment, enhanced participants' self-esteem and confidence in decision-making leading to changes in AGYW's sexual risk behaviors.

Keywords: Adolescent girls; Cash transfers; Empowerment; Sexual and reproductive health; Tanzania; Young women.

MeSH terms

  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • Empowerment*
  • Female
  • Financing, Government
  • Focus Groups
  • HIV Infections / epidemiology
  • HIV Infections / prevention & control*
  • HIV Infections / psychology
  • Humans
  • Public Assistance*
  • Qualitative Research
  • Reproductive Health
  • Risk-Taking
  • Sexual Behavior
  • Sexual Partners
  • Tanzania / epidemiology
  • Unsafe Sex / prevention & control*
  • Young Adult