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Financial Incentives May Increase Viral Suppression in HIV

No increase in linkage to care, but increase noted in viral suppression and continuity of care

TUESDAY, June 20, 2017 (HealthDay News) — For HIV-positive patients, financial incentives can lead to increased viral suppression, according to a study published online June 19 in JAMA Internal Medicine.

Wafaa M. El-Sadr, M.D., from Columbia University in New York City, and colleagues conducted a large community-based clinical trial that randomized 37 HIV test and 39 HIV care sites to financial incentives or standard of care.

The researchers found that financial incentives did not increase linkage to care within three months, as indicated by CD4+ and/or viral load test results done at a care site (adjusted odds ratio, 1.10; 95 percent confidence interval, 0.73 to 1.67; P = 0.65). However, there was a correlation for financial incentives with increased viral suppression. Compared with standard-of-care sites, at financial-incentive sites the overall proportion of patients with viral suppression was 3.8 percent higher (95 percent confidence interval, 0.7 to 6.8 percent; P = 0.01). At financial-incentive sites, the proportion of patients virally suppressed was 4.9 percent higher (95 percent confidence interval, 1.4 to 8.5 percent; P = 0.007) among patients not previously consistently virally suppressed. At financial-incentive sites, continuity in care was 8.7 percent higher (95 percent confidence interval, 4.2 to 13.2 percent; P < 0.001).

“Financial incentives offer promise for improving adherence to treatment and viral suppression among HIV-positive patients,” the authors write.

Two authors disclosed financial ties to the pharmaceutical industry.

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