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Effectiveness of Financial Incentives in Achieving UNAID Fast-Track 90-90-90 and 95-95-95 Target of HIV Care Continuum: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

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Abstract

Financial incentives influence behavioural changes and the current review was done to assess the effectiveness of this intervention in improving HIV care continuum. We conducted systematic searches in MEDLINE, Cochrane library, ScienceDirect and Google Scholar from inception until July 2019. We carried out a meta-analysis with random-effects model quantifying inconsistency (I2) for heterogeneity and reported pooled Risk Ratios (RR) with 95% confidence intervals (CIs). A total of 22 studies with 38,119 participants were included. All the six outcomes showed better results in financial incentive arm compared to standard care with statistical significance in three outcomes—HIV testing uptake (pooled RR: 2.42; 95%CI 1.06–5.54; I2 = 100%), antiretroviral therapy (ART) adherence (pooled RR: 1.30; 95%CI 1.13–1.50; I2 = 44%), and continuity in care (pooled RR: 1.24; 95%CI 1.09–1.41; I2 = 86%). To summarize, financial incentives can be helpful in improving the uptake of HIV testing, ART adherence and continuity of care while it was better for achieving viral load suppression among studies conducted in high-income countries.

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Authors and Affiliations

  1. Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605006, India

    Yuvaraj Krishnamoorthy & Tanveer Rehman

  2. State Program and Technical Manager, Cap TB project, AP/TS Unit, Solidarity and Action against The HIV Infection in India (SAATHII), Hyderabad, India

    Manikandanesan Sakthivel

Authors
  1. Yuvaraj Krishnamoorthy
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  2. Tanveer Rehman
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  3. Manikandanesan Sakthivel
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Contributions

All authors contributed to the study conception and design. Preparation of protocol, literature review data extraction and analysis were performed by YK, TR and MS. The first draft of the manuscript was written by YK and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Yuvaraj Krishnamoorthy.

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Krishnamoorthy, Y., Rehman, T. & Sakthivel, M. Effectiveness of Financial Incentives in Achieving UNAID Fast-Track 90-90-90 and 95-95-95 Target of HIV Care Continuum: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. AIDS Behav 25, 814–825 (2021). https://doi.org/10.1007/s10461-020-03038-2

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