Pre-Analysis Plan: Health Certification in the Market for Sex Work

Female sex workers (FSWs) are disproportionately affected by HIV and other sexually transmitted infections (STIs), with HIV prevalence estimated at 37% in Sub-Saharan Africa. To bring FSWs into the health system, several countries have adopted registration programs, which allow participating FSWs to avoid some criminal penalties if they adhere to monthly screening and treatment for STIs. Registration programs have two key components: they reduce the probability that a registered FSW has an STI; and they provide a registration card certifying participants’ low STI risk. In partnership with a community-based organization, (Association AWA) and a local research organization (Reseau Africain de Recherche sur le Sida) in Dakar, Senegal, I implemented a randomized experiment to study the effect of health certification on sex work and HIV risk among FSWs. This study will provide the first evidence on the causal impact of registration programs, and will help illuminate the reasons for low take-up of registration programs.