Incentivizing Prevention: Community Based Organizations' Perceptions on Financial Incentives for Recruitment and...

While financial incentivization has been found to significantly increase HIV retesting, receipt of HIV test results, and viral suppression, little research has examined community-based organizations (CBOs) perspectives on implementing financial incentives. We interviewed 22 CBOs related to implementing financial incentives for client engagement in a digital HIV prevention intervention, Keep It Up! (KIU!). KIU! was designed with and for young men who have sex with men (YMSM) who tested HIV-negative to maintain their negative status by reducing risk and enhancing protection. Most CBOs changed their incentive amounts and structures across two years of implementation to attempt to increase recruitment and retention. CBOs originally proposed a mean of $39 incentive in their applications for funding. One year later, the average incentive increased to $40, and then $68 the next year. Most CBO staff felt incentives may be effective in increasing recruitment, retention, and engagement. They highlighted the role of incentives in alleviating social determinants of health. Nearly a third of staff, though, felt the size of incentives may not be high enough. Further, these staff highlighted that incentives may be most helpful in recruiting participants but less beneficial for retention and engagement. Our analysis is among the first to examine CBO staff perceptions of implementing financial incentives for digital HIV prevention interventions in the U.S. Future research is needed to assess the effectiveness of financial incentivization of digital HIV prevention interventions and to identify the amount an incentive should be to increase recruitment and retention.Trial Registration: NCT03896776.