Financial incentives to improve re-engagement in HIV care

Results from a randomized pilot study

Bibliographic Data

ID19440968
AuthorsRebecca Hémono (0000-0003-3753-9344, University of California, Berkeley, corresponding author), Nicole K Kelly (0000-0003-1061-2767, University of California, Berkeley), Carolyn A Fahey (0000-0001-9865-2397, University of California, Berkeley), Kassim Hassan (Management and Development for Health), Janeth Msasa (Management and Development for Health), Rashid Mfaume (Ministry of Health, Community Development, Gender, Elderly and Children), Rashid S Mfaume (Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania), Prosper Njau (0000-0002-6351-9489, Ministry of Health, Community Development, Gender, Elderly and Children), Prosper F Njau (Health for a Prosperous Nation, Dar es Salaam, Tanzania), William H Dow (0000-0002-4080-1668, University of California, Berkeley), Sandra I Mccoy (0000-0002-4764-9195, University of California, Berkeley)
Year2023
Volume35
Issue7
Pages935-941
Publication date2023-07-03
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueAIDS Care (JOURNAL)
Journal identifiersISSN: 0954-0121 • E-ISSN: 1360-0451
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/09540121.2022.2041164
PMID35187992
OpenAlexW4212836596
LanguageEN
Citations received2
References cited20

Objective Determine the feasibility, acceptability, and preliminary effectiveness of financial incentives to motivate re-engagement in HIV care in Shinyanga, Tanzania.Methods Out-of-care people living with HIV (PLHIV) were identified from medical records in four clinics and home-based care providers (HBCs) from April 13, 2018 to March 3, 2020. Shinyanga Region residents, ≥18 years, who were disengaged from care were randomized 1:1 to a financial incentive (∼$10 USD) or the standard of care (SOC), stratified by site, and followed for 180 days. Primary outcomes were feasibility (located PLHIV who agreed to discuss the study), acceptability (enrollment among eligibles), and re-engagement in care (clinic visit within 90 days).Results HBCs located 469/1,309 (35.8%) out-of-care PLHIV. Of these, 215 (45.8%) were preliminarily determined to be disengaged from care, 201 (93.5%) agreed to discuss the study, and 157 eligible (100%) enrolled. Within 90 days, 71 (85.5%) PLHIV in the incentive arm re-engaged in care vs. 58 (78.4%) in the SOC (Adjusted Risk Difference [ARD] = 0.08, 95% CI: −0.03, 0.19, p = 0.09). A higher proportion of incentivized PLHIV completed an additional (unincentivized) visit between 90–180 days (79.5% vs. 71.6%, ARD = 0.10, 95% CI: −0.03, 0.24, p = 0.13) and remained in care at 180 days (57.8% vs. 51.4%, ARD = 0.07, 95% CI: −0.09, 0.22, p = 0.40).Conclusions Short-term financial incentives are feasible, acceptable, and have the potential to encourage re-engagement in care, warranting further study of this approach

Business · Family medicine · Geography · Incentive · Randomized controlled trial · Tanzania · Global Maternal and Child Health · HIV/AIDS Research and Interventions · Medicine · Poverty, Education, and Child Welfare · Emergency Medicine · Finance · Internal Medicine

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