A professor from the Brown University School of Public Health has just published a review in Lancet HIV which examines the effects conditional economic incentives can have on human immunodeficiency virus (HIV) treatment and prevention outcomes in low and middle income countries. The review was done by Dr. Omar Galagarra, an associate professor of health services, policy and practice at Brown and Dr. Sandra G-Sosa Rubi, from the National Institute of Public Health in Cuernavaca, Mexico. Conditional economic incentives refer to when a participant is given a financial reward in exchange for exhibiting or performing a behavior or task that can be objectively measured.
They searched Cochrane Library, PubMed, Health Evidence, EconLit, ProQuest, and ClinicalTrials.gov for articles in January and June 2019 and screened 596 records. They looked at the effects rewards have on HIV treatment and prevention in four domains: testing and counselling, HIV prevention, linkage to care and initiation of anti-retroviral therapy and finally, retention in care, treatment adherence and viral suppression.
They found in that conditional economic incentives, like cash incentives, improved outcomes in some cases. These results were stronger for HIV prevention and testing than they were for linkage to care and retention in care outcomes; which produced null or variable results. Among other suggestions, the authors suggest integrating incentives as part of the first step of HIV care and suggest further research on how incentives can reduce high risk behaviors and increase protective activities.Friday Letter Submission, Publish on October 11