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What's next for HIV prevention? Paying people to be healthy
Roger Pebody, 2011-07-25 12:40:00
Researchers are investigating the impact of offering financial incentives to people who are at risk of acquiring or passing on HIV, the International AIDS Society conference in Rome heard last week.
A large study in the United States is looking at whether a test-and-treat approach should be supported by offering incentives to newly diagnosed people who attend medical services and maintain an undetectable viral load.
In sub-Saharan Africa, a number of studies are investigating whether providing incentives to adolescent girls who remain in education reduces their long-term HIV risk.
Such approaches are not without their critics, but those participating in a conference symposium on the topic mostly felt that these interventions are trying to tackle structural factors and have the potential to be effective, especially when used alongside other prevention interventions.
“We shouldn’t look at behavioural economics as the new magic bullet,” commented Professor Quarraisha Abdool Karim of the Centre for the AIDS Programme of Research in South Africa (CAPRISA). “This fits into a broader combination approach,” she said.
As well as cash, incentives may take the form of food or shopping vouchers. They are sometimes called conditional cash transfers, and the approach is sometimes referred to as contingency management.
The idea is already widely used in the development field (often aiming to impact poverty or education), and increasingly in relation to health.
For example, in one study, employees who received cash to complete a smoking cessation programme and to remain smoke-free six and twelve months later had much higher quit rates. People who wanted to lose weight have been more successful when they have had financial incentives, either as a reward or as a lottery prize that can only be won by individuals who have met their weight-loss target.
The conference heard about approaches that provide incentives for people to use preventative health services; incentives for people to remain infection-free; and incentives for pupils to remain in school.
Source:1
