A Pilot Trial of an Unconditional Cash Transfer for Pregnant Women With HIV in Botswana

What this Trial Is About

Researchers are evaluating an unconditional cash transfer intervention to improve mental capacity, antiretroviral therapy (ART) adherence, and postpartum retention among pregnant women with HIV in Botswana. This pilot Hybrid Type 2 effectiveness-implementation trial aims to answer whether monthly cash transfers improve mental bandwidth and ART adherence during pregnancy and postpartum compared to usual care. It also assesses the feasibility and acceptability of delivering cash transfers via mobile money in public antenatal clinics and explores barriers and facilitators to implementation. The study enrolls 100 pregnant women with HIV in their second trimester, randomly assigned to two groups: one receives usual care plus 1,000 Botswana Pula (BWP) monthly cash transfers through six months postpartum, and the other receives usual care with standard social support. Participants attend visits at baseline, late pregnancy prior to delivery, and three to six months postpartum. Selected participants will also take part in qualitative interviews to explore their experiences with the intervention. Throughout the study, participants complete surveys, mental bandwidth assessments using the Psychomotor Vigilance Task and Raven's Progressive Matrices, and clinical data are collected from electronic health records. The study measures ART adherence, mental bandwidth, feasibility, and acceptability of the cash transfer intervention at specified visits. Secondary outcomes include food security, stress, psychological distress, pregnancy status, birth outcomes, and clinic attendance. Findings will guide future larger trials and policy development.

Cash Transfers to Pregnant Women With HIV