People with HIV who do not have a fully suppressed viral load despite being on antiretrovirals (ARVs) are more likely to succeed on treatment if they are promised cash incentives contingent upon a contract with their medical provider to adhere well to the daily regimen, aidsmap reports.

Publishing their findings in the journal AIDS, researchers conducted a single-center randomized controlled trial of 110 people who were on ARVs for at least six months but nevertheless had a viral load above 200.

Forty people were randomized to two study arms. Those individuals in the first, known as the provider visit incentive arm, received a $30 cash incentive to make it to their scheduled HIV clinic appointments; those in the second, known as the incentive choice arm, received a $30 cash incentive to attend their appointments but also had to sign an an agreement with their health care provider to adhere to their ARVs at a rate of 90 percent or greater, lest they forfeit the cash incentive. An additional 70 people were enrolled in a non-randomized arm that received standard HIV care.

Adherence was measured with electronic pill container caps.

All study participants were scheduled to attend five follow-up visits for which they were given the cash incentives. About three months after the last of these visits, they were summoned for a surprise sixth visit to measure their viral load.

At that sixth visit, 68 percent of those in the incentive choice arm had a fully suppressed viral load, compared with 43 percent of those in the provider visit incentive arm and 41 percent of those in the control arm. Those in the incentive choice arm were 3.93 times more likely to be virally suppressed at this point compared with those in the control arm.

To read the aidsmap article, click here.

To read the study abstract, click here.