UC Berkeley researchers find connection between cash incentives, HIV care

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Antiretroviral therapy can help extend the length and improve the quality of life for people living with HIV, but the treatment requires daily adherence, which can be difficult for patients with fewer resources. (Photo by NIAID under CC BY-SA 4.0)

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A study by UC Berkeley researchers from the School of Public Health found that small financial incentives promote the use of HIV services among patients in Tanzania.

Currently, there are about 38 million people living with HIV globally. The study, which lasted about a year and a half, sought to determine whether the size of a financial incentive for clinic attendance would affect viral suppression in HIV-positive adults using antiretroviral therapy, or ART. 

“We demonstrated that short-term economic support, in the form of a short-term cash transfer, can significantly improve the likelihood that people are able to comply with their HIV treatment in the vulnerable window when they are starting HIV treatment,” said Sandra McCoy, study co-author and associate professor in residence of epidemiology and biostatistics at UC Berkeley, in an email.

From April to December of 2018, 530 participants were randomly assigned to one of three groups: a control group, a smaller incentive group and a larger incentive group. The control group did not receive cash, while the other groups received 10,000 Tanzanian shillings, about $4.50, and 22,500 Tanzanian shillings, about $10, respectively.

The groups received the cash incentives each time they attended monthly clinic visits for six months.

After that period of time, 73% of the control group, 83% of the smaller incentive group and 86% of the larger incentive group remained in care. Ultimately, the researchers found a positive correlation between the cash incentive size and viral suppression, but they did not find much difference between the two incentive groups.

ART can help extend the length and improve the quality of life, but in order for treatment to work, patients have to adhere to it daily, according to McCoy. This can be a challenge in areas with fewer resources because of a lack of access to health care and because many people residing in those areas have to make hard decisions between HIV treatments, clinic visits and necessities such as food and school.

According to McCoy, socioeconomic status, as well as social and cultural norms, are factors in HIV risk and life expectancy. As encouraging as HIV-related biomedical advances are, they are usually felt last, if at all, by those in poverty, McCoy added.

There are myriad ways to support economic well-being, and the financial incentives showcased through this study are only one form of support, according to McCoy. She added that she looks forward to seeing a larger variety of treatment and prevention options for people living with HIV.

“We hope that our study will inspire a new generation of studies that aim to develop new ways to support the health of people living with HIV by bolstering their economic well being,” McCoy said in an email.

Contact Mela Seyoum at [email protected] and follow her on Twitter at @melaseyoum.