The study therefore gives policymakers a specific prediction of how much a program would cost to have high participation, and how much money and how many lives it might save.
"The target population seems generally very well-disposed to participate in these types of programs at prices which are consistent with other social programs currently in place in Mexico for preventing other health risks," Galrraga said.
Men on the street
To gather the large sampling of data, the researchers recruited and trained young members of Mexico City's gay community in 2008 to present the surveys to their peers in discotheques, metro stations, bars, and streets in the city's red-light district. The interviewers briefly explained that they were conducting a survey about HIV risk behaviors and ways to reduce infection.
Consenting subjects were then given a handheld computer with software that administered the confidential and anonymous 40-minute survey. The intentionally discreet technique, Galrraga said, allowed the survey process to appear as if each subject was simply using a cell phone.
The survey software asked subjects about personal traits, risk behaviors, such as the number of recent sex partners and condom use, and health, and then took them through a bidding and bargaining exercise in which they ultimately declared the level of payment they'd accept for participating in either or both of two programs: monthly talks about HIV prevention and STI testing and quarterly check-ins to verify a pledge of remaining STI free.
Monitoring for STIs, Galrraga said, is a proxy for monitoring HIV risk behaviors.
"You want to condition on something you can observe," Galrraga said. "The ultimate goal is to reduce the number of sex partners and to increase the use of condoms to increase safe sex but that cannot be observed directly. A reduction in the incidence of STI's is correlated with the ultimate goal."
|Contact: David Orenstein|