Financial incentives can motivate some HIV patients to take HIV antiretroviral therapy

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HIV AIDS

Researchers have found that offering financial incentives can motivate some HIV patients to take up HIV antiretroviral therapy (ART) medication regularly and maintain viral load suppression.

The findings of the HPTN 065 study could have implications for improving health outcomes and decreasing the risk of transmitting the virus to others. HPTN 065 was a large, multi-component study that explored the feasibility of implementing a community-focused strategy to expand HIV testing, diagnose PLWH, and link them to medical care to begin and stay on treatment. Study findings were published today in JAMA Internal Medicine.

According to the U.S. Centers for Disease Control and Prevention (CDC) 15 per cent of the 1.1 million people in the U.S. living with HIV do not know they have it, and that only 55 per cent of those living with diagnosed HIV are virally suppressed. Enabling people who are unaware of their HIV infection to get tested, engage in care, initiate ART and achieve viral suppression allows them a better chance of living longer, healthier lives and greatly reduces their risk of passing the virus on to their sexual partners.

HPTN 065 evaluated the effect of financial incentives to encourage PLWH to take their ART medication regularly, thereby keeping their viral load suppressed. The study was conducted at 39 care sites across the Bronx, New York and Washington, DC. Half of these sites were randomly assigned to offer financial incentives, while the other half operated according to their normal procedures.

The study found a nearly 4 per cent increase in the number of PLWH with suppressed viral load at care sites offering financial incentives compared to those that did not (standard of care sites). At the peak of the intervention, after financial incentives had been in place for 18 months, the study found an overall increase of 5 per cent in the number of PLWH with a suppressed viral load at sites offering the incentives. Financial incentives also increased how regularly PLWH came for clinic visits. The number of PLWH consistently returning for care was higher by 9 per cent at sites offering financial incentives compared with standard of care sites.

“Even a seemingly modest increase in the percent of people with viral suppression has the potential for considerable clinical and preventive benefits, especially on a population level, as we strive to achieve viral suppression in 90 per cent of PLWH on ART,” said Dr. Wafaa El-Sadr, HPTN Principal Investigator and study chair. “Garnering the benefits of HIV treatment for the individual and the community are important priorities and both require achieving high levels of control of HIV.”

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