Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Current HIV/AIDS Reports
Erschienen in: Current HIV/AIDS Reports 5/2022

31.08.2022 | The Science of Prevention (R Heffron and K Ngure, Section Editors)

Using Behavioral Economics to Support PrEP Adherence for HIV Prevention

verfasst von: Unmesha Roy Paladhi, David A. Katz, Carey Farquhar, Harsha Thirumurthy

Erschienen in: Current HIV/AIDS Reports | Ausgabe 5/2022

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

We explored different behavioral economics (BE) mechanisms through which pre-exposure prophylaxis (PrEP) initiation and adherence could be impacted and examined recent work using BE principles to further HIV prevention efforts. We also generated new intervention ideas based on existing HIV testing and ART adherence literature.

Recent Findings

There is limited work that uses BE principles to design interventions to increase PrEP initiation and adherence, mostly involving financial incentives. The recent works highlighted involve financial incentives and demonstrate that key populations are open to accepting monetary incentives to increase PrEP initiation and improve adherence. However, there are mixed results on the long-term impacts of using incentives to modify behavior.

Summary

While there are a few ongoing studies that utilize BE principles to increase PrEP use, there is need to develop studies that test these concepts, to promote PrEP initiation and adherence. We suggest methods of exploring non-incentives-based ideas to increase PrEP use in key populations.
Literatur
1.
Rice T. The behavioral economics of health and health care. Annu Rev Public Health. 2013;34(1):431–47.CrossRef
2.
Charness G, Gneezy U. Incentives to exercise. Econometrica. 2009;77(3):909–31.CrossRef
3.
Volpp KG, John LK, Troxel AB, Norton L, Fassbender J, Loewenstein G. Financial incentive-based approaches for weight loss: a randomized trial. JAMA. 2008;300(22):2631–7.CrossRef
4.
Volpp KG, Troxel AB, Pauly MV, Glick HA, Puig A, Asch DA, et al. A randomized, controlled trial of financial incentives for smoking cessation. N Engl J Med. 2009;360(7):699–709.CrossRef
5.
Banerjee AV, Duflo E, Glennerster R, Kothari D. Improving immunisation coverage in rural India: clustered randomised controlled evaluation of immunisation campaigns with and without incentives. The BMJ. 2010;17(340):c2220.CrossRef
6.
Lacetera N, Macis M, Slonim R. Economic rewards to motivate blood donations. Science. 2013;340(6135):927–8.CrossRef
7.
O’Donoghue T, Rabin M. Doing It Now or Later. Am Econ Rev. 1999;89(1):103–24.CrossRef
8.
Tiefenbeck V, Goette L, Degen K, Tasic V, Fleisch E, Lalive R, et al. Overcoming salience bias: how real-time feedback fosters resource conservation. Manag Sci. 2018;64(3):1458–76.CrossRef
9.
•• Linnemayr S. HIV prevention through the lens of behavioral economics. JAIDS J Acquir Immune Defic Syndr. 2015;68(4):e61. This article forms an important base for the mechanisms through which BE principles can be effective for HIV prevention.CrossRef
10.
•• Linnemayr S, MacCarthy S, Wagner Z, Barreras JL, Galvan FH. Using behavioral economics to promote HIV prevention for key populations. J AIDS Clin Res. 2018;9(11):780. This short communication highlights important factors to consider when designing financial incentives, including non-monetary incentives, in order for them to be most effective.CrossRef
11.
Loewenstein G. Hot-cold empathy gaps and medical decision making. Health Psychol Off J Div Health Psychol Am Psychol Assoc. 2005;24(4S):S49-56.
12.
•• Salinas-Rodríguez A, Sosa-Rubí SG, Chivardi C, Rodríguez-Franco R, Gandhi M, Mayer KH, et al. Preferences for conditional economic incentives to improve pre-exposure prophylaxis adherence: a discrete choice experiment among male sex workers in Mexico. AIDS Behav. 2022;26(3):833–42. This DCE demonstrated that key populations theoretically prefer a fixed-structure incentives payment compared to a lottery-based payment scheme.CrossRef
13.
•• Celum CL, Gill K, Morton JF, Stein G, Myers L, Thomas KK, et al. Incentives conditioned on tenofovir levels to support PrEP adherence among young South African women: a randomized trial. J Int AIDS Soc. 2020;23(11):e25636. This study showed that incentives may increase PrEP adherence for 3 months among adolescent girls and young women, though the trend may not be sustainable.CrossRef
14.
•• LeGrand S, Knudtson K, Benkeser D, Muessig K, Mcgee A, Sullivan PS, et al. Testing the efficacy of a social networking gamification app to improve pre-exposure prophylaxis adherence (P3: Prepared, Protected, emPowered): protocol for a randomized controlled trial. JMIR Res Protoc. 2018;7(12): e10448. This large-scale ongoing study of an app that dispenses incentives to encourage PrEP adherence is indicative of the possible uses and importance of using BE principles to design PrEP adherence studies.CrossRef
15.
Garrison LE, Haberer JE. Pre-exposure prophylaxis uptake, adherence, and persistence: a narrative review of interventions in the US. Am J Prev Med. 2021;61(5, Supplement 1):S73-86.CrossRef
16.
Lee R, Cui RR, Muessig KE, Thirumurthy H, Tucker JD. Incentivizing HIV/STI testing: a systematic review of the literature. AIDS Behav. 2014;18(5):905–12.CrossRef
17.
Haukoos JS, Witt MD, Coil CJ, Lewis RJ. The effect of financial incentives on adherence with outpatient human immunodeficiency virus testing referrals from the emergency department. Acad Emerg Med Off J Soc Acad Emerg Med. 2005;12(7):617–21.CrossRef
18.
Thornton RL. The demand for, and impact of, learning HIV status. Am Econ Rev. 2008;98(5):1829–63.CrossRef
19.
Nglazi MD, van Schaik N, Kranzer K, Lawn SD, Wood R, Bekker LG. An incentivized HIV counseling and testing program targeting hard-to-reach unemployed men in Cape Town, South Africa. J Acquir Immune Defic Syndr 1999. 2012;59(3):e28-34.CrossRef
20.
Chamie G, Kwarisiima D, Ndyabakira A, Marson K, Camlin CS, Havlir DV, et al. Financial incentives and deposit contracts to promote HIV retesting in Uganda: a randomized trial. PLOS Med. 2021;18(5):e1003630.CrossRef
21.
Montoy JCC, Dow WH, Kaplan BC. Cash incentives versus defaults for HIV testing: a randomized clinical trial. PLoS ONE. 2018;13(7):e0199833.CrossRef
22.
Chamie G, Schaffer EM, Ndyabakira A, Emperador DM, Kwarisiima D, Camlin CS, et al. Comparative effectiveness of novel non-monetary incentives to promote HIV testing: a randomized trial. AIDS Lond Engl. 2018;32(11):1443–51.CrossRef
23.
Sibanda EL, Tumushime M, Mufuka J, Mavedzenge SN, Gudukeya S, Bautista-Arredondo S, et al. Effect of non-monetary incentives on uptake of couples’ counselling and testing among clients attending mobile HIV services in rural Zimbabwe: a cluster-randomised trial. Lancet Glob Health. 2017;5(9):e907–15.CrossRef
24.
Fahey CA, Njau PF, Katabaro E, Mfaume RS, Ulenga N, Mwenda N, et al. Financial incentives to promote retention in care and viral suppression among HIV-positive adults initiating antiretroviral therapy in Tanzania: a three-arm randomised controlled trial. Lancet HIV. 2020;7(11):e762–71.CrossRef
25.
Mccoy SI, Njau PF, Fahey C, Kapologwe N, Kadiyala S, Jewell NP, et al. Cash versus food assistance to improve adherence to antiretroviral therapy among HIV-infected adults in Tanzania: a randomized trial. AIDS Lond Engl. 2017;31(6):815–25.CrossRef
26.
Stecher C, Mukasa B, Linnemayr S. Uncovering a behavioral strategy for establishing new habits: evidence from incentives for medication adherence in Uganda. J Health Econ. 2021;1(77):102443.CrossRef
27.
Thirumurthy H, Ndyabakira A, Marson K, Emperador D, Kamya M, Havlir D, et al. Financial incentives for achieving and maintaining viral suppression among HIV-positive adults in Uganda: a randomized trial. Lancet HIV. 2019;6(3):e155–63.CrossRef
28.
Ndyabakira A, Getahun M, Byamukama A, Emperador D, Kabageni S, Marson K, et al. Leveraging incentives to increase HIV testing uptake among men: qualitative insights from rural Uganda. BMC Public Health. 2019;19(1):1763.CrossRef
29.
Adamson B, El-Sadr W, Dimitrov D, Gamble T, Beauchamp G, Carlson JJ, et al. The cost-effectiveness of financial incentives for viral suppression: HPTN 065 Study. Value Health. 2019;22(2):194–202.CrossRef
30.
Silverman K, Holtyn AF, Rodewald AM, Siliciano RF, Jarvis BP, Subramaniam S, et al. Incentives for viral suppression in people living with HIV: a randomized clinical trial. AIDS Behav. 2019;23(9):2337–46.CrossRef
31.
Dunlap LJ, Orme S, Zarkin GA, Holtgrave DR, Maulsby C, Rodewald AM, et al. Cost and cost-effectiveness of incentives for viral suppression in people living with HIV. AIDS Behav [Internet]. 2021 Aug 26 [cited 2021 Oct 24]; Available fromhttps://​doi.​org/​10.​1007/​s10461-021-03439-x.
32.
World Health Organization. Regional Office for Europe. Pandemic fatigue: reinvigorating the public to prevent COVID-19: policy considerations for Member States in the WHO European Region [Internet]. World Health Organization. Regional Office for Europe; 2020 [cited 2021 Oct 24]. Report No.: WHO/EURO:2020–1160–40906–55390. Available from: https://​apps.​who.​int/​iris/​handle/​10665/​335820. Accessed 24 Apr 2022.
Metadaten
Titel
Using Behavioral Economics to Support PrEP Adherence for HIV Prevention
verfasst von
Unmesha Roy Paladhi
David A. Katz
Carey Farquhar
Harsha Thirumurthy
Publikationsdatum
31.08.2022
Verlag
Springer US
Erschienen in
Current HIV/AIDS Reports / Ausgabe 5/2022
Print ISSN: 1548-3568
Elektronische ISSN: 1548-3576
DOI
https://doi.org/10.1007/s11904-022-00624-y

Weitere Artikel der Ausgabe 5/2022

Current HIV/AIDS Reports 5/2022 Zur Ausgabe

Implementation Science (E Geng and J Iwelunmor, Section Editors)

Applying Behavioural Insights to HIV Prevention and Management: a Scoping Review

Complications of HIV and Antiretroviral Therapy (GA McComsey, Section Editor)

Ectopic Fat and Cardiac Health in People with HIV: Serious as a Heart Attack

Co-infections and Comorbidity (D Bhattacharya, Section Editor)

Bone Quality in Relation to HIV and Antiretroviral Drugs

eHealth and HIV (J Stekler and D Katz, Section Editors)

HIV Care Meets Telehealth: a Review of Successes, Disparities, and Unresolved Challenges

eHealth and HIV (J Stekler and D Katz, Section Editors)

Ingestible Electronic Sensors for Monitoring Real-time Adherence to HIV Pre-exposure Prophylaxis and Antiretroviral Therapy

The Science of Prevention (R Heffron and K Ngure, Section Editors)

Long-Acting Injectable Cabotegravir for HIV Prevention: What Do We Know and Need to Know about the Risks and Consequences of Cabotegravir Resistance?

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren. 

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Die „Zehn Gebote“ des Endokarditis-Managements

30.04.2024 Endokarditis Leitlinie kompakt

Worauf kommt es beim Management von Personen mit infektiöser Endokarditis an? Eine Kardiologin und ein Kardiologe fassen die zehn wichtigsten Punkte der neuen ESC-Leitlinie zusammen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise