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Integrating Financial Incentives for Viral Load Suppression into HIV Care Coordination Programs: Considerations for
Gina F Gambone1, Matthew B Feldman, Anna Y Thomas-Ferraioli
1New York City Department of Health and Mental Hygiene, Queens, New York (Mss Gambone and Thomas-Ferraioli and Dr Feldman); Housing Works Community Healthcare, Brooklyn, New York (Dr Shubert); and University of Pennsylvania, Philadelphia, Pennsylvania (Dr Ghose).
Journal of Public Health Management and Practice : JPHMP
|August 1, 2020
Summary
Financial incentives (FIs) effectively support durable viral load suppression (VLS) in people with HIV (PLWH). This study details implementing FIs within a multilevel adherence program to improve VLS outcomes.
Area of Science:
- Implementation Science
- Public Health Interventions
- HIV/AIDS Research
Background:
- Durable viral load suppression (VLS) is crucial for HIV management and prevention.
- Financial incentives (FIs) show promise in efficacy trials for promoting VLS.
- Real-world implementation data for FI interventions among people living with HIV (PLWH) are limited.
Purpose of the Study:
- To describe considerations for developing and implementing FI interventions.
- To inform the scale-up of a multilevel treatment adherence support program.
- To increase VLS among PLWH in New York City.
Main Methods:
- The Undetectables VLS Program, including quarterly $100 FIs for VLS, was developed and pilot tested.
- The program was scaled up by integrating it into existing services across 7 agencies in New York City over 3 years (2016-2019).
- Program performance will be measured using quality indicators like FI receipt and VLS rates.
Main Results:
- Pilot evaluation demonstrated a statistically significant positive effect on VLS.
- The scale-up integrated the program into existing HIV services for PLWH.
- Ongoing evaluation will track program performance and impact.
Conclusions:
- Packaging FIs with adherence strategies and integrating them into service systems are key recommendations.
- Organization-wide buy-in is essential for successful FI implementation.
- Further implementation science research is needed to sustain evidence-based FI interventions.
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