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Science Magazine Highlights Use of Cash Incentives in Large US-Based HIV Study

July 12, 2012

ICAP Director Wafaa El-Sadr is featured in Science magazine’s July 13 special issue, “HIV/AIDS in America.”

In “Pay Now, Benefits May Follow,” author Jon Cohen features the work that Dr. El-Sadr and colleagues in the HIV Prevention Trials Network (HPTN) are conducting to assess a novel approach to encourage newly diagnosed HIV positive people to seek care and adhere to HIV treatment. The unique study gives people who test HIV positive a coupon for a gift card to claim after they complete clinic visits and laboratory tests. Patients who achieve viral suppression also receive gift cards as a reward and motivation for a maximum of four times a year.

Dr. El-Sadr is protocol chair for the study, called HPTN 065 or Test Link to Care Plus Treat (TLC-Plus) Study. She brought attention to the enduring HIV epidemic in the US with her landmark 2010 paper entitled “AIDS in America: Forgotten but not gone” in the New England Journal of Medicine. HPTN 065 is being conducted in the Bronx and in Washington, DC and involves 37 HIV testing sites and 39 HIV care sites in the two cities with four non-intervention cities participating—Chicago, Miami, Houston, and Philadelphia.

Community input played an important role in the design of the study, Dr. El-Sadr explained. “Before we introduced our financial incentive, we had to think so carefully about what can happen that’s good and what can undermine what you’re trying to do,” she said. “And we want to use incentives that, if they are effective, will be cost-effective for health systems.”

HPTN 065 aims to determine the feasibility of enhanced testing, linkage, and treatment as a strategy for HIV prevention in the US. The study is funded by the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute of Mental Health (NIMH), and the US Centers for Disease Control and Prevention (CDC). The study is conducted in collaboration with CDC and health departments in all participating cities. Read more in Pay Now, Benefits May Follow.” (Subscription required)