Long-Term Effects of Incentives for HIV Viral Suppression: A Randomized Clinical Trial
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Novak, Matthew D., August F. Holtyn, Forrest Toegel, Andrew M. Rodewald, Jeannie-Marie Leoutsakos, Michael Fingerhood, and Kenneth Silverman. “Long-Term Effects of Incentives for HIV Viral Suppression: A Randomized Clinical Trial.” AIDS and Behavior 28, no. 2 (February 1, 2024): 625–35. https://doi.org/10.1007/s10461-023-04249-z.
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This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s10461-023-04249-z
Abstract
Achieving viral suppression in people living with HIV improves their quality of life and can help end the HIV/AIDS epidemic. However, few interventions have successfully promoted HIV viral suppression. The purpose of this study was to evaluate the long-term effectiveness of financial incentives for viral suppression in people living with HIV. People living with a detectable HIV viral load (≥200 copies/mL) were randomly assigned to Usual Care (n=50) or Incentive (n=52) groups. Incentive participants earned up to $10 per day for providing blood samples with an undetectable or reduced viral load. During the 2-year intervention period, the percentage of blood samples with a suppressed viral load was significantly higher among Incentive participants (70%) than Usual Care participants (43%) (OR=7.1, 95% CI 2.7 to 18.8, p<.001). This effect did not maintain after incentives were discontinued. These findings suggest that frequent delivery of large-magnitude financial incentives for viral suppression can produce large and long-lasting improvements in viral load in people living with HIV. ClinicalTrials.gov Identifier: NCT02363387.