Here is a review of glucagon-like peptide-1 receptor agonist use in people with HIV.
|Articles|July 9, 2020
Cash for Clinic Visits: Financial Incentive Boosts HIV Viral Suppression
Author(s)Grant M. Gallagher
Investigators in Tanzania trialed modest, automated financial incentives for clinic attendance on viral suppression for patients initiating ART.
Advertisement
Past study supports the use of direct monetary incentives to improve retention in HIV care and antiretroviral therapy (ART) adherence. But few assessments have examined the impact of such policies on biological outcomes, and few have compared the impact of different incentive amounts.
Investigators in Tanzania trialed modest, automated financial incentives for clinic attendance on viral suppression for patients initiating ART. Findings were presented at the
The study design included a 3-arm parallel-group randomized control process. At 4 clinics in the Shinyanga region, investigators recruited adults living with HIV who initiated ART fewer than 30 days prior in order to assess how viral load outcomes might vary between the 3 groups at the end of the trial period.
Between April-December 2018, 530 participants were allocated (1:1:1) to the control group or to receive a monthly cash incentive, conditional on clinic attendance, of either 10,000 TZS ('US $4.50) or 22,500 TZS ('US $10.00).
There were 184 patients in the control group, 174 in the larger incentive group, and 172 in the smaller incentive group.
Monetary transfers were delivered for up to 6 months via mobile health technology which monitored attendance and disbursed payments autonomously. The team then evaluated the relationship between incentive size and viral suppression (<1000 copies/ml) at 6 months using logistic regression.
By 6 months, about 73.0% of participants in the control group remained on ART and achieved viral suppression, compared to 82.9% in the smaller incentive group [risk difference (RD)=9.9, 95% CI: 1.2'18.5] and 86.1% in the larger incentive group (RD=13.1, 95% CI: 4.5'21.5)
Testing trends showed a positive relationship between increasing incentive size and viral suppression (OR=1.10 per 2500 TZS, 95% CI: 1.03 to 1.17, p-trend=0.003), although the pairwise comparisons suggest a threshold effect.
Improvements were seen among all pre-specified secondary outcomes, such as retention on ART and appointment attendance.
“Small, automated financial incentives improved retention in care and viral suppression among adults starting ART in Tanzania. These findings strengthen the evidence for implementing incentives within standard HIV care,” the presentation authors concluded.
Related AIDS 2020 Coverage:
Advertisement
Related to this article
In the third episode of the series with Perry N. Halkitis, PhD, MS, MPH, he discusses how human behavior as well as other factors play a significant role in repeating outbreaks.
In the second episode of the series with Perry N. Halkitis, PhD, MS, MPH, he brings his personal experience to this topic and questions whether there should be a shift in who manages the primary care needs of these patients.
The federal agency gave the nod for the smallest once-daily single tablet regimen available for virologically suppressed adults with HIV, including those on complex regimens. The approval is based on the results of the 2 phase 3 ARTISTRY trials.
The federal agency gave the nod to dolutegravir (Tivicay PD), making it the first second-generation integrase inhibitor cleared for children with HIV weighing at least 2 kg, including eligible newborns.
In mid-May, as the world was still grappling with an unexpected hantavirus outbreak aboard a tourism vessel, news broke of an Ebola outbreak in the Ituri Province of the Democratic Republic of the Congo spanning at least 3 health zones, including Bunia, Rwampara, and Mongbwalu.
In this week's top infectious disease stories, a Pennsylvania teen became the state's fourth measles death in weeks, the CDC reported a 17% summer surge in rabies exposure calls, new research revisited whether cefepime raises mortality risk, a multihospital review examined ceftriaxone's safety after state alerts, and examining Legionella pneumonia diagnostics.
The latest CDC numbers show a 5.37% increase of measles cases from week-to-week. In Pennsylvania, the fourth measles-related death was reported in 2026. Additionally, the CDC has made a change in the way it will report deaths.