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Study Finds Financial Incentives Can Enhance Viral Suppression Among HIV-Positive Persons in the US

June 19, 2017

Columbia Researcher Leads Study that Finds Financial Incentives Can Enhance Viral Suppression Among HIV-Positive Persons in the US

Achievement of viral suppression among HIV-positive persons is critical for their individual health as well as for prevention of HIV transmission to others. This has motivated global efforts to identify all individuals living with HIV, to link them to HIV care, to offer and initiate antiretroviral therapy among such individuals, and to support them to achieve and maintain viral suppression. However, data indicate that only 55% of those diagnosed with HIV in the US achieve viral suppression.

Findings from the HPTN 065 Study showed that use of financial incentives can result in enhanced viral suppression with potential for improved health for such patients as well as for prevention of HIV transmission to others.

The HPTN 065 Study was a community-based clinical trial conducted in the Bronx, New York and Washington, D.C., two communities severely affected by HIV. The study included 37 HIV test sites and 39 HIV care sites, which were randomly assigned to use financial incentives or their standard procedures to enhance linkage to care of HIV-positive patients and viral suppression among those on HIV treatment. The study was led by Dr. Wafaa El-Sadr, director of ICAP and professor of epidemiology and medicine at Columbia University’s Mailman School of Public Health, conducted by the HIV Prevention Trials Network (HPTN) and funded by the National Institutes of Health.

Findings from the study which were published in JAMA Internal Medicine, showed that the use of gift cards significantly increased viral suppression and clinic attendance among HIV-positive patients at HIV care sites that offered financial incentives. Overall, there was approximately a four-percent higher percentage of patients with viral suppression at financial incentive care sites compared to sites not offering gift cards. Additionally, at the financial incentive care sites, there was an approximately five-percent higher viral suppression noted among subgroup of patients who previously had not shown consistent viral suppression. However, financial incentives had no significant effect in connecting those found to be HIV-positive to care.

“Effective interventions are needed to garner the benefits of antiretroviral therapy for the individual and for society,” said Dr. El-Sadr. “The results of this study are encouraging and should motivate efforts to pursue the further assessment of using financial incentives in HIV treatment programs and to determine their potential impact when scaled up.”