Behavioral Economics Incentives to Support HIV Treatment Adherence in Sub-Saharan Africa

Summary

This study will implement an intervention in a two-year randomized controlled trial (RCT) to establish efficacy on viral suppression as a biological endpoint, compare the effectiveness of two different modes of implementation (including one entirely based on readily available clinic data), and investigate cost-effectiveness. Participants in the first intervention group (T1, n=110) will be eligible for small lottery prizes based on timely clinic visits, and qualify for an annual lottery conditional if demonstrating viral suppression; those in the second group (T2, n=110) will draw prizes conditional on electronically measured adherence at each clinic visit, and also participate in an annual lottery that is conditional on high adherence throughout the year. The control group (n=110) will receive the usual standard of care. Assessments will be conducted at baseline and then every six months. Primary outcomes are undetectable viral load and electronically measured adherence.

Conditions

• HIV/AIDS

Interventions

BEHAVIORAL

Incentivization based on high adherence

When a participant comes for a regular clinic visit, s/he will have the MEMS data extracted, and if adherence over the previous month \>=90%, will participate in a prize drawing.

BEHAVIORAL

Incentivization based on timely clinic visit

When a participant comes for a regular clinic visit on the day s/he is scheduled, s/he will participate in a prize drawing.

BEHAVIORAL

Annual adherence prize drawing

Participants will have a chance to take part in an annual drawing where eligibility is based on the average adherence during that year.

BEHAVIORAL

Annual viral suppression-based prize drawing

Participants will have a chance to take part in an annual drawing where eligibility is based on showing viral suppression.

BEHAVIORAL

Year 2 booster

Those participants not showing viral suppression at month 12 will be randomized in a 1:1 fashion to receive an additional intervention component or continue receiving the same intervention arm as in Year 1.

Sponsors & Collaborators

• National Institute of Mental Health (NIMH)

  collaborator NIH

• Mildmay Uganda Limited

  collaborator OTHER

• RAND

  lead OTHER

Principal Investigators

• Sebastian Linnemayr, PhD · RAND

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

SEQUENTIAL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2018-04-11

Primary Completion

2023-10-02

Completion

2023-10-02

Countries

• Uganda

Study Locations