The role of financial incentives in the treatment of children and adolescents infected with human immunodeficiency virus

Abstract

Adherence to antiretroviral therapy (ART) is one of the most important issues in pediatric patients living with Human Immunodeficiency Virus (HIV). Combined with the fact that young patients face a large array of adherence barriers, interventions that can increase adherence are of great interest. Financial incentives (FIs) are a novel approach in pediatric HIV settings, and have not been studied previously in this disease for this age group. Thus, we sought to evaluate the effects FIs had in helping pediatric HIV patients achieve and maintain virologic suppression (VS). Furthermore, a post-incentive survey was administered to evaluate the self-perceived effects of FIs.

In our study, FIs were not associated with achieving VS among pediatric and adolescent patients. The post-incentive survey has demonstrated many aspects of patients' and guardians' perceptions of FIs that should be considered in future FI studies. First, it was likely that patients who effectively grasped the concept of financial reward were most positively influenced by FIs. Second, the study data suggested that FIs may be contra-effective to those patients who report strong emotional responses to negative outcomes. Further and more comprehensive studies are required to fully characterize these effects.