A commitment contract to achieve virologic suppression in poorly adherent patients with HIV/AIDS

AIDS
Marcella AlsanVincent C Marconi

Abstract

Assess whether a commitment contract informed by behavioral economics leads to persistent virologic suppression among HIV-positive patients with poor antiretroviral therapy (ART) adherence. Single-center pilot randomized clinical trial and a nonrandomized control group. Publicly funded HIV clinic in Atlanta, Georgia, USA. The study involved three arms. First, participants in the provider visit incentive (PVI) arm received $30 after attending each scheduled provider visit. Second, participants in the incentive choice arm were given a choice between the above arrangement and a commitment contract that made the $30 payment conditional on both attending the provider visit and meeting an ART adherence threshold. Third, the passive control arm received routine care and no incentives. A total of 110 HIV-infected adults with a recent plasma HIV-1 viral load more than 200 copies/ml despite ART. The sample sizes of the three groups were as follows: PVI, n = 21; incentive choice, n = 19; and passive control, n = 70. Virologic suppression (plasma HIV-1 viral load ≤200 copies/ml) at the end of the incentive period and at an unanticipated postincentive study visit approximately 3 months later. The odds of suppression were higher in the incen...Continue Reading

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Citations

Dec 6, 2019·Nature Reviews. Rheumatology·Alexis Ogdie, David A Asch
Aug 20, 2019·Current Opinion in HIV and AIDS·Jonathan A Colasanti, Wendy S Armstrong
Jun 14, 2019·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Wafaa M El-SadrUNKNOWN HPTN 065 Study

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