This project will evaluate the impact of a combined economic and psychosocial intervention on individual-level and household-level economic outcomes and sexual/reproductive health outcomes, among youth and young people ages 18 to 30 in a rural area of southern Tanzania. In addition to assessing impact using standard indicators of sexual/ reproductive health and economic well-being, we will examine links between gender-based power and increased con- trol in the domain of sexual and reproductive health attributable to the intervention on economic outcomes. We thus explore a key and understudied pathway linking sexual/reproductive health investments to microeconomic outcomes, including earnings, patterns of household consumption, and levels of savings and investment.

The economic component of the intervention involves the use of “conditional cash transfers” (CCT) to prevent HIV, other sexually transmitted infections (STIs), and unintended preg- nancy by linking cash payments to negative laboratory test results, assessed on a quarterly basis. The psychosocial compo- nent involves gender-based counseling and “life skills” training to increase basic financial literacy, address gender/power ineq- uities, and to encourage deliberate decisionmaking in sexual and reproductive health (including the prevention of HIV, other STIs, and unintended pregnancy). We will test the hypothesis that a system of rapid feedback and positive rein- forcement using cash as a primary incentive to reduce risky sexual behavior, coupled with counseling and life skills train- ing, will result in enhanced economic well-being in both the immediate/short term and medium term in the lives of study participants (males and females), in addition to improved sex- ual/reproductive health outcomes.