Economic hardship and lower socioeconomic status are known barriers to HIV testing and retention in care. But what if you could incentivize people to seek testing and remain in treatment?

It’s a question Dr. Miguel Reina Ortiz, a USF College of Public Health (COPH) associate professor, and Neielle Saint-Cyr, a COPH MPH student and graduate research assistant working with Reina, have set out to answer using a scoping review of the literature on the use of behavioral and traditional economic interventions to improve HIV-related care. 

They were joined in the research by others from the COPH, including Drs. Henian Chen, Alida Gertz, Dinorah Martinez Tyson and Stephanie Marhefka-Day (now with the College of Nursing).

Their review was recently presented at the American College of Academic International Medicine’s annual conference held in June. Saint-Cyr, who’s concentrating in epidemiology and global communicable disease, was awarded Best Original Research Presentation for her poster presentation highlighting the research.

“Looking at the effects of behavioral and traditional economics on people living with HIV is important because it will help identify another form of effective intervention to either prevent HIV infections or improve the behaviors of those living with HIV,” Saint-Cyr said.

Some of the incentives Saint-Cyr and her colleagues looked at were:

• Conditional cash transfers, in which participants were given money if an action—like completing HIV testing or treatment—was completed.
• Unconditional cash transfers (money was given regardless if an action was completed)
• Microfinance loans (small loans given if an action was completed)
• Gamification (participants were able to download online or iPhone video games as a reward for completing an action).

The majority of the studies Saint-Cyr and her group looked at showed positive results—meaning the incentives showed an uptake in HIV care. Incentives, she said, caused people to be more consistent with HIV testing, taking their medication if diagnosed with HIV and meeting with their health care providers. 

“I believe incentives work because they help motivate people and may help provide access to care for some individuals,” Saint-Cyr noted. “For people who are unable to travel to providers to receive care, incentives (which can sometimes be cash, gift cards and bus passes) may help them pay for travel expenses. Incentives may also help those who are unable to purchase food.”

Saint-Cyr said next steps are to continue exploring the effectiveness of using financial incentives to promote HIV testing and care, particularly among Latinos living with HIV in the South. 

“There is a research gap in Latino and Hispanic communities due to a lack of focus on minority health,” she said. “Minority health tends to not be prioritized. Additionally, there is research lacking on low-income populations in high-income countries because of a lack of health equity, and minorities tend to be part of these low-income communities. Our findings will help fill in gaps and ultimately contribute to the growing body of evidence that will support effective programs for diagnosing HIV, treating it and achieving viral suppression.” 

Story by Donna Campisano, USF College of Public Health