Innovative Incentive Strategies for Sustainable HIV Testing and Antiretroviral Treatment
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 3,580
- 试验地点
- 1
- 主要终点
- Proportion of participants who complete all HIV retest visits at study venue
研究概览
简要总结
The success of combination HIV prevention efforts, including HIV treatment as prevention, hinges on universal, routine HIV testing with effective treatment after HIV diagnosis. The proposed study will evaluate the comparative effectiveness and sustainability of innovative incentive strategies, informed directly by behavioral economics and decision psychology, to promote HIV testing among men and HIV treatment among HIV-infected adults in rural Uganda.
详细描述
[INTRODUCTION]
The success of combination HIV prevention efforts, including HIV treatment as prevention, hinges on universal, routine HIV testing with linkage to care and antiretroviral treatment initiation after HIV diagnosis. The proposed study will evaluate the comparative effectiveness and sustainability of innovative incentive strategies, informed directly by behavioral economics and decision psychology, to promote HIV testing among men and HIV and treatment among HIV-infected adults in rural Uganda.
[OBJECTIVES]
AIM 1: Adult men living in the study communities in rural Uganda (N=3,000) will be randomized to one of three (fixed, loss aversion, and lottery) incentive approaches and different incentive amounts that encourage HIV testing. The hypothesis is that lottery and loss aversion incentives will result in significantly higher testing uptake than fixed incentives. The investigators also hypothesize that the proportion of testers in each arm who are HIV-infected (secondary outcome) will be highest with lottery-based incentives. In sub-samples of men who do and do not test, the investigators will conduct in-depth interviews to assess perceptions, attitudes and preferences related to incentives that may affect how incentives influence testing.
AIM 2: Adult men and women living in the study communities (N=400) who obtained an HIV-positive result at a community health campaign will be randomized into one of two incentive approaches that encourage HIV treatment adherence. The investigators hypothesize that a financial incentive will be more effective than no incentive in promoting HIV virologic suppression (a measure of success in ART adherence and navigation of the HIV treatment cascade) as incentives capitalize on present bias by drawing attention to a salient, immediate benefit of initiating and/or maintaining treatment, and leverage loss aversion by generating implicit loss as a result of delaying the decision to initiate ART.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Other
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •≥18 years
- •Resident (≥6 months) in one of 4 study communities
排除标准
- •Plan to move <6 months from study start
- •AIM 2 - TREATMENT TRIAL
- •Inclusion Criteria:
- •≥18 years
- •Resident (≥6 months) in one of 4 study communities
- •HIV positive
- •Exclusion Criteria:
- •Plan to move <6 months from study start
- •AIM 3 - REPEAT TESTING PILOT
- •Inclusion Criteria:
- •HIV-negative by rapid HIV antibody testing at pilot trial baseline,
- •Ages 18 - 59 years old,
- •Attendee of high-risk site of HIV acquisition (e.g. bars, trading centers, etc.) in the region
- •Exclusion Criteria:
- •Intention to move away from the community in the 3 months from time of recruitment
- •AIM 3 - REPEAT TESTING TRIAL
- •Inclusion Criteria:
- •HIV-negative by rapid HIV antibody testing at time of recruitment,
- •Ages 18 - 59 years old,
- •Reported willingness to retest for HIV in the six months following recruitment,
- •Sexual risk behavior, defined as at least one of the following self-reported risks in the 12 months prior to recruitment:
- •>1 sexual partner, or
- •known HIV-infected sexual partner, or
- •sexually transmitted infection, or
- •paid or received compensation or gifts for sex.
- •Exclusion Criteria:
- •Intention to move away from the community for >=4 consecutive months during the six months following recruitment
- •A history of testing for HIV >=3 times in the 12 months prior to recruitment
结局指标
主要结局
Proportion of participants who complete all HIV retest visits at study venue
时间窗: 6 months
Aim 3 Trial (IBIS Repeat HIV Testing Trial) primary outcome
Proportion of participants who receive an HIV test at a community health campaign between intervention groups
时间窗: 6-8 weeks after enrollment; annually
Aim 1 (IBIS HIV Testing Trial) primary outcome
Proportion of participants with HIV RNA <400 copies/mL between intervention groups
时间窗: 6 months after enrollment
Aim 2 (IBIS Treatment Trial) primary outcome
Proportion of participants randomized to loss aversion trial who make a deposit
时间窗: At enrollment
Aim 3 Pilot (IBIS Repeat HIV Testing Trial) primary outcome
次要结局
- Proportion of participants who have HIV positive result between intervention groups(6-8 weeks after enrollment; annually)
- Proportion of participants who retest for HIV at 6 months among those who made deposits(6-7 months after enrollment)
- Cumulative incidence of HIV seroconversion(6-7 months after enrollment)
- Proportion of participants who receive an HIV test at a testing site between intervention groups(1-3 months after enrollment)
- Proportion of participants who retest for HIV at study venue at 3 months(3-4 months after enrollment)
- Proportion of participants who retest for HIV at study venue at 6 months(6-7 months after enrollment)
- Proportion of participants who retest for HIV at 3 months among those who made deposits(3-4 months after enrollment)