The world has made great strides toward ending AIDS. Yet the deadly disease remains a critical development challenge for poor countries. Sub-Saharan Africa, which has only 12 percent of the global population, is home to about 68 percent of all people living with HIV. Improving rates of HIV testing in order to identify and counsel infected people is necessary for halting transmission of the virus and ensuring that people who are infected can get treated. The challenge is how to improve rates of testing, especially among couples where one partner is infected and either doesn t know or hasn t told the partner. Increasingly, pay-for-performance is being considered as an option for improving health care for pregnant women and children. Development experts and policymakers are interested in whether bonus payments can work in other areas of health care, such as improving the rate of HIV testing and treatment, especially in couples. evaluation found that the payments increased the likelihood that people who were part of a couple would get tested, showing that pay-for-performance could be a route for improving testing (and thus making available information on how to prevent HIV transmission) among those who face risk of infection from their partner. The results are particularly important for Sub-Saharan Africa, where according to 2009 World Health Organization data, nearly 80 percent of HIV-infected adults are unaware of their HIV status, and more than 90 percent don t know if their partners are infected.
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