# Effects of a prosocial intervention among sellers of HIV and reproductive health supplies on young women’s health

> **NIH NIH R03** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2023 · $80,750

## Abstract

SUMMARY
In sub-Saharan Africa, adolescent girls and young women (AGYW; ages 15-24) face the dual threats of
unintended pregnancy and HIV, but struggle to access critical preventive health services, such as HIV testing
and contraception. As discreet and convenient access points, private sector drug shops have the potential to
amplify access among AGYW, as demonstrated by our R34 pilot of our Malkia Klabu (“Queen Club”)
intervention in Tanzania, a loyalty program that creates AGYW-friendly drug shops where AGYW can access
contraception and HIV prevention services. While our pilot showed great potential for Malkia Kalbu to increase
AGYW demand for such services at drug shops, shopkeepers were reluctant to continue service provision to
AGYW beyond the study period. AGYW products were perceived to yield low profits, despite shopkeepers
recognizing the benefit of increased AGYW patronage and expressing desires to support broader community
health in their role as first point of care. Thus, private providers need additional motivation to independently
support service provision to AGYW, even when consumer demand is high.
Building on our planned cluster-randomized control trial (CRCT) our Malkia Klabu AGYW program in Tanzania
(R01MH12451601), we proposed to pilot-test 2 strategies that bolster shopkeepers’ motivations to distribute
AGYW SRH products: (1) privately giving AGYW customer feedback to shopkeepers to leverage prosocial
motivation, and; (2) publicly giving AGYW customer feedback with peer comparisons to leverage social image
motivations. Based on insights from behavioral economics (BE) and the mixed-methods results from our pilot,
our novel interventions aim to harness shopkeepers’ intrinsic prosocial motivation towards AGYW and
tendency to compare themselves with their peers. We hypothesize that providing customer feedback from
AGYW to socially-motivated shopkeepers will encourage distribution of contraception and HIVST, especially
when feedback is publicly displayed.
To that end, we have designed a mixed-methods R03 study that leverages the research infrastructure and
implementation from our parent R01 CRCT. Our proposed study will assess the effect of these strategies on
shopkeepers’ distribution of HIVST and contraceptives to AGYW (Aim 1), and use mixed-methods to
understand shopkeepers’ experiences and assess to what extent treatment mechanisms through prosocial
motivation and social image theory drive behavior change (Aim 2). Specifically, we will cross-randomize the
initial condition (i.e., No Feedback, Private Feedback, and Public Feedback) across the parent R01 CRCT’s
120 enrolled drug shops, with progressive phase-in of additional intervention conditions for each group over 18
months. If feasible and with preliminary evidence of effectiveness, we will develop our enhanced Malkia Klabu
program for a future R01 sustainability study. Our study’s focus on increasing AGYW’s access to contraception
matches the Population Dynamics Branch’s res...

## Key facts

- **NIH application ID:** 10706507
- **Project number:** 5R03HD109561-02
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Jenny Xin Liu
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $80,750
- **Award type:** 5
- **Project period:** 2022-09-20 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10706507

## Citation

> US National Institutes of Health, RePORTER application 10706507, Effects of a prosocial intervention among sellers of HIV and reproductive health supplies on young women’s health (5R03HD109561-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10706507. Licensed CC0.

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