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Patient-Centered, Culturally Responsive Behavioral Economics Intervention to Optimize Retention in HIV Care
Vinita Sharma1, Alida Gertz2, Neille Saint-Cyr3
1Department of Community and Global Health, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA.
Summary
Culturally responsive behavioral economics interventions show promise for improving HIV care retention among Latinos living with HIV. Patient and provider input is key to developing acceptable and effective incentive-based strategies.
Area of Science:
- Behavioral economics
- Public health
- Health disparities
Background:
- Behavioral economics optimizes decision-making and has improved HIV outcomes.
- Culturally responsive methods are used in HIV interventions but not yet for behavioral economics-based ones.
- Optimizing retention in care for HIV (RICH) among Latinos living with HIV (LLHIVs) is a critical public health goal.
Purpose of the Study:
- To identify patient-centered perspectives for culturally responsive development of behavioral economics interventions.
- To explore the use of incentives to optimize RICH among LLHIVs.
- To adapt existing cultural responsiveness frameworks for HIV behavioral economics interventions.
Main Methods:
- Semistructured interviews with HIV care providers and LLHIVs.
- Utilized a modified Ecological Validity and Cultural Sensitivity framework for interview guides.
- Qualitative analysis of participant perspectives on incentives, cultural factors, and barriers.
Main Results:
- Nonrestrictive monetary incentives like gift cards were deemed acceptable.
- Participants emphasized intrinsic motivation for HIV care over incentives.
- Language, wording, stigma, and discrimination were identified as crucial considerations.
Conclusions:
- Behavioral economics interventions are feasible for engaging LLHIVs in RICH.
- Cultural responsiveness can enhance intervention acceptability and effectiveness.
- Further research is needed to evaluate real-world effectiveness in diverse populations.
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