Epidemiology and Social Financial incentives to increase pediatric HIV testing: a randomized trial
Date
2021Author
Njuguna, Irene N
Anjuli D, Wagner,
Jilliana, Neary,
Omondi, Vincent O
Otieno, Verlinda A
Anita, Orimba
Mugo, Cyrus
Babigumira, Joseph B.
Carol, Levin
Richardson, Barbra A
Maleche-Obimbo, Elizabethi
Wamalwa, Dalton C
John-Stewart, Grace
Slyker, Jenanifer
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
Background:
Financial incentives can motivate desirable health behaviors, including adult HIV testing. Data regarding the effectiveness of financial incentives for HIV testing in children, who require urgent testing to prevent mortality, are lacking.
Methods:
In a five-arm unblinded randomized controlled trial, adults living with HIV attending 19 HIV clinics in Western Kenya, with children 0–12 years of unknown HIV status, were randomized with equal allocation to $0, $1.25, $2.50, $5 or $10. Payment was conditional on child HIV testing within 2 months. Block randomization with fixed block sizes was used; participants and study staff were unblinded at randomization. Primary analysis was intent-to-treat, with predefined primary outcomes of completing child HIV testing and time to testing.
Results:
Of 452 caregivers, 90, 89, 93, 92 and 88 were randomized to $0, $1.25, $2.50, $5.00, and $10.00, respectively. Of those, 31 (34%), 31 (35%), 44 (47%), 51 (55%), and 54 (61%) in the $0, $1.25, $2.50, $5.00, and $10.00 arms, respectively, completed child testing. Compared with the $0 arm, and adjusted for site, caregivers in the $10.00 arm had significantly higher uptake of testing [relative risk: 1.80 (95% CI 1.15--2.80), P = 0.010]. Compared with the $0 arm, and adjusted for site, time to testing was significantly faster in the $5.00 and $10.00 arms [hazard ratio: 1.95 (95% CI 1.24--3.07) P = 0.004, 2.42 (95% CI 1.55--3.79), P < 0.001, respectively).
Conclusion:
Financial incentives are effective in improving pediatric HIV testing among caregivers living with HIV.
URI
https://journals.lww.com/aidsonline/Abstract/2021/01010/Financial_incentives_to_increase_pediatric_HIV.13.aspxhttp://erepository.uonbi.ac.ke/handle/11295/154853
Citation
Njuguna, Irene N., et al. "Financial incentives to increase pediatric HIV testing: a randomized trial." AIDS 35.1 (2021): 125-130.Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
- Faculty of Health Sciences (FHS) [10385]
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