Financial Incentives Offer Promise in Improving HIV Viral Suppression

HealthDay News — For HIV-positive patients, financial incentives increase viral suppression, according to a study published in JAMA Internal Medicine.

Wafaa M. El-Sadr, MD, from Columbia University in New York City, and colleagues conducted a large community-based clinical trial that randomized 37 HIV test and 39 HIV care sites to financial incentives or standard of care.

The researchers found that financial incentives did not increase linkage to care within 3 months, as indicated by CD4+ and/or viral load test results done at a care site (adjusted odds ratio, 1.10; 95% confidence interval, 0.73 to 1.67; P =.65). However, there was a correlation for financial incentives with increased viral suppression.

Compared with standard-of-care sites, at financial-incentive sites the overall proportion of patients with viral suppression was 3.8% higher (95% confidence interval, 0.7% to 6.8%; P =.01). At financial-incentive sites, the proportion of patients virally suppressed was 4.9% higher (95% confidence interval, 1.4% to 8.5%; P =.007) among patients not previously consistently virally suppressed. At financial-incentive sites, continuity in care was 8.7% higher (95% confidence interval, 4.2% to 13.2%; P <.001).

“Financial incentives offer promise for improving adherence to treatment and viral suppression among HIV-positive patients,” the researchers write.

Two authors disclosed financial ties to the pharmaceutical industry.

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El-Sadr WM, Donnell D, Beauchamp G, et al. Financial incentives for linkage to care and viral supression among HIV-positive patients- a randomized clinical trial (HPTN 065) [published online June 19, 2017]. JAMA Intern Med. doi:10.1001/jamainternmed.2017.2158