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Title A pilot randomized trial of incentive strategies to promote HIV retesting in rural Uganda.
Full text https://escholarship.org/uc/item/8sb8c932
Date 2020
Author(s) Chamie, Gabriel; Ndyabakira, Alex; Marson, Kara G; Emperador, Devy M; Kamya, Moses R; Havlir, Diane V; Kwarisiima, Dalsone; Thirumurthy, Harsha
Abstract BackgroundRetesting for HIV is critical to identifying newly-infected persons and reinforcing prevention efforts among at-risk adults. Incentives can increase one-time HIV testing, but their role in promoting retesting is unknown. We sought to test feasibility and acceptability of incentive strategies, including commitment contracts, to promote HIV retesting among at-risk adults in rural Uganda.MethodsAt-risk HIV-negative adults were enrolled in a pilot trial assessing feasibility and acceptability of incentive strategies to promote HIV retesting three months after enrollment. Participants were randomized (1:1:3) to: 1) no incentive; 2) standard cash incentive (~US$4); and 3) commitment contract: participants could voluntarily make a low- or high-value deposit that would be returned with added interest (totaling ~US$4 including the deposit) upon retesting or lost if participants failed to retest. Contracts sought to promote retesting by leveraging loss aversion and addressing present bias via pre-commitment. Outcomes included acceptability of trial enrollment, contract feasibility (proportion of participants making deposits), and HIV retesting uptake.ResultsOf 130 HIV-negative eligible adults, 123 (95%) enrolled and were randomized: 74 (60%) to commitment contracts, 25 (20%) to standard incentives, and 24 (20%) to no incentive. Of contract participants, 69 (93%) made deposits. Overall, 93 (76%) participants retested for HIV: uptake was highest in the standard incentive group (22/25 [88%]) and lowest in high-value contract (26/36 [72%]) and no incentive (17/24 [71%]) groups.ConclusionIn a randomized trial of strategies to promote HIV retesting among at-risk adults in Uganda, incentive strategies, including commitment contracts, were feasible and had high acceptability. Our findings suggest use of incentives for HIV retesting merits further comparison in a larger trial.Trial registrationClinicalTrials.gov identifier: NCT:02890459.
Subject(s) Humans; HIV Infections; Mass Screening; Risk Factors; Pilot Projects; Motivation; Adult; Rural Population; Uganda; Female; Male; Clinical Trials and Supportive Activities; Prevention; Clinical Research; Infectious Diseases; HIV/AIDS; 3.1 Primary prevention interventions to modify behaviours or promote wellbeing; General Science & Technology
Coverage e0233600
Publisher eScholarship, University of California
Type of publication article
Format application/pdf
Source PloS one, vol 15, iss 5
Rights public
Identifier qt8sb8c932
Repository Berkeley - University of California
Added to C-A: 2022-01-10;13:55:34